Provider Demographics
NPI:1982167474
Name:LOVING HEAL PSYCHIATRIC SERVICES LLC
Entity type:Organization
Organization Name:LOVING HEAL PSYCHIATRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAKEW
Authorized Official - Middle Name:
Authorized Official - Last Name:ADNEW
Authorized Official - Suffix:
Authorized Official - Credentials:DNP,PMHNP-BC
Authorized Official - Phone:206-235-8112
Mailing Address - Street 1:22634 10TH AVE S
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-6915
Mailing Address - Country:US
Mailing Address - Phone:206-235-8113
Mailing Address - Fax:206-653-7300
Practice Address - Street 1:22634 10TH AVE S
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-6915
Practice Address - Country:US
Practice Address - Phone:206-235-8113
Practice Address - Fax:206-653-7300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty