Provider Demographics
NPI:1366071342
Name:LOVELEE 4LIFE LLC
Entity type:Organization
Organization Name:LOVELEE 4LIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYONIE
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:561-800-3500
Mailing Address - Street 1:860 US HIGHWAY 1 STE 102C
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3879
Mailing Address - Country:US
Mailing Address - Phone:561-800-3500
Mailing Address - Fax:561-237-1978
Practice Address - Street 1:860 US HIGHWAY 1 STE 102C
Practice Address - Street 2:
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-3879
Practice Address - Country:US
Practice Address - Phone:561-800-3500
Practice Address - Fax:561-237-1978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No332900000XSuppliersNon-Pharmacy Dispensing Site