Provider Demographics
NPI:1982283644
Name:LAUVE'S PPECC LUBBOCK LLC
Entity type:Organization
Organization Name:LAUVE'S PPECC LUBBOCK LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:SIMON
Authorized Official - Last Name:LAUVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-465-5494
Mailing Address - Street 1:10917 WHISPERING PATH DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106
Mailing Address - Country:US
Mailing Address - Phone:318-465-5494
Mailing Address - Fax:
Practice Address - Street 1:14 BRIERCROFT OFFICE PARK
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412-3035
Practice Address - Country:US
Practice Address - Phone:318-465-5494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-07
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care