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NPI Code Detail

MEDICARE: LOVELIFE FAMILY SERVICES L.L.C

MEDICARE: LOVELIFE FAMILY SERVICES L.L.C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyNV20131188171NV

General Provider Information

NPI Number : 1003177171
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOVELIFE FAMILY SERVICES L.L.C
Provider Business Mailing Address
First Line : 6330 MCLEOD DR STE 3
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-4431
Country : US
Telephone Number : 702-754-3484
Fax Number : 702-629-7952
Provider Business Practice Location Address
First Line : 6330 MCLEOD DR STE 3
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-4431
Country : US
Telephone Number : 702-754-3484
Fax Number : 702-629-7952
Authorized Official
Title or Position : ADMINISTRATOR
Name : CLEVONNE FUNCHES
Credential :
Telephone Number : 702-754-3484
Provider Enumeration Date : 06/05/2012
Last Update Date : 03/10/2016

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