Provider Demographics
NPI:1154730935
Name:A GIFT OF LOVE
Entity type:Organization
Organization Name:A GIFT OF LOVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JERMEL
Authorized Official - Middle Name:U
Authorized Official - Last Name:ROYAL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:718-772-7484
Mailing Address - Street 1:841 LAFAYETTE AVE
Mailing Address - Street 2:1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-1901
Mailing Address - Country:US
Mailing Address - Phone:718-772-7484
Mailing Address - Fax:
Practice Address - Street 1:841 LAFAYETTE AVE
Practice Address - Street 2:1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-1901
Practice Address - Country:US
Practice Address - Phone:718-772-7484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health