Provider Demographics
NPI:1699330753
Name:A LOVING PLACE
Entity type:Organization
Organization Name:A LOVING PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MABAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-217-5746
Mailing Address - Street 1:2925 SAND OAK LOOP
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-1455
Mailing Address - Country:US
Mailing Address - Phone:321-217-5746
Mailing Address - Fax:
Practice Address - Street 1:3871 YOTHERS RD
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-5825
Practice Address - Country:US
Practice Address - Phone:321-217-5746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-04
Last Update Date:2019-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health