MEDICARE: LOVE & LIFE WELLNESS, LLC.

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	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1346937265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVE & LIFE WELLNESS, LLC.

Provider Business Mailing Address
First Line	:	3900 FORD RD PH D
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-2045
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3900 FORD RD PH D
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-2045
Country	:	US
Telephone Number	:	215-397-7104
Fax Number	:

Authorized Official
Title or Position	:	CRNP
Name	:	WALETTRA ENOCH
Credential	:
Telephone Number	:	215-397-7104

Provider Enumeration Date	:	04/20/2023
Last Update Date	:	04/20/2023

Similar Medicare Providers

1154279677 — DANA MORRIS RN
Practice Location Address:

100 LEVERINGTON AVE APT 50
PHILADELPHIA, PA
19127-2045

Practice Phone: 609-410-7757
Practice Fax:

1760718472 — MINSEC TREATMENT LLC
Practice Location Address:

1625 WASHINGTON AVE
PHILADELPHIA, PA
19146-2045

Practice Phone: 215-732-1890
Practice Fax: 215-732-2063

1457893208 — JESSICA ASHLEY STILWELL ATC
Practice Location Address:

2045 GREEN ST APT 2F
PHILADELPHIA, PA
19130-3246

Practice Phone: 908-432-2351
Practice Fax:

1083264691 — CARING WITH INTEGRITY HOME CARE
Practice Location Address:

7175 OGONTZ AVE STE B
PHILADELPHIA, PA
19138-2045

Practice Phone: 215-941-8181
Practice Fax:

1831313535 — MERAKEY PARKSIDE RECOVERY
Practice Location Address:

5000 PARKSIDE AVE
PHILADELPHIA, PA
19131-4714

Practice Phone: 215-836-3131
Practice Fax: 215-273-5975

1417805540 — DR. ERIC MOORE PHD
Practice Location Address:

4064 CONSHOHOCKEN AVE # A31
PHILADELPHIA, PA
19131-2826

Practice Phone: 248-217-5743
Practice Fax:

Directions to “LOVE & LIFE WELLNESS, LLC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.