Provider Demographics
NPI:1124771688
Name:A MOTHERS LOVE
Entity type:Organization
Organization Name:A MOTHERS LOVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIZZY
Authorized Official - Middle Name:R
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-417-9914
Mailing Address - Street 1:1227 WESTMORELAND DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-1465
Mailing Address - Country:US
Mailing Address - Phone:336-417-9914
Mailing Address - Fax:
Practice Address - Street 1:1227 WESTMORELAND DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-1465
Practice Address - Country:US
Practice Address - Phone:336-417-9914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness