Provider Demographics
NPI:1194502914
Name:LOVE IS LOVE COMMUNITY HEALTH SERVICES INC
Entity type:Organization
Organization Name:LOVE IS LOVE COMMUNITY HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IVY
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEETWINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-285-9982
Mailing Address - Street 1:4 MONTAIGNE CT APT 1B
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3067
Mailing Address - Country:US
Mailing Address - Phone:443-208-6570
Mailing Address - Fax:
Practice Address - Street 1:1700 REISTERSTOWN RD STE 222
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-2924
Practice Address - Country:US
Practice Address - Phone:240-285-9982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty