MEDICARE: LOVETT'S FOSTERCARE

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	385HR2055X	Child Mental Illness Respite Care	1107747706	FL

General Provider Information

NPI Number	:	1881865582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVETT'S FOSTERCARE

Provider Business Mailing Address
First Line	:	2250 NW 172ND TER
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056-4624
Country	:	US
Telephone Number	:	305-621-1021
Fax Number	:	305-626-9310

Provider Business Practice Location Address
First Line	:	2250 NW 172ND TER
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056-4624
Country	:	US
Telephone Number	:	305-621-1021
Fax Number	:	305-626-9310

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. SELINA SPENCER
Credential	:	MS
Telephone Number	:	305-621-1021

Provider Enumeration Date	:	03/20/2008
Last Update Date	:	03/20/2008

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