MEDICARE: LOVE IS PATIENCE HEALTH & WELLNESS

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
1	251S00000X	Community/Behavioral Health Agency	NV20181437177	NV

General Provider Information

NPI Number	:	1043704471
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVE IS PATIENCE HEALTH & WELLNESS

Provider Business Mailing Address
First Line	:	1050 WHITNEY RANCH DR APT 1925
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-2547
Country	:	US
Telephone Number	:	213-422-1650
Fax Number	:

Provider Business Practice Location Address
First Line	:	1915 SIMMONS ST APT 2130
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-1560
Country	:	US
Telephone Number	:	213-422-1650
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	COMMORAH LYLES - MAY
Credential	:
Telephone Number	:	213-422-1650

Provider Enumeration Date	:	06/19/2018
Last Update Date	:	06/19/2018

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