Provider Demographics
NPI:1174104392
Name:LOVING ARMS OUTREACH COMMUNITY CENTER INC.
Entity type:Organization
Organization Name:LOVING ARMS OUTREACH COMMUNITY CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:JEREMIAH
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-696-4135
Mailing Address - Street 1:17688 71ST LN N
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-5501
Mailing Address - Country:US
Mailing Address - Phone:954-696-4135
Mailing Address - Fax:
Practice Address - Street 1:17688 71ST LN N
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-5501
Practice Address - Country:US
Practice Address - Phone:954-696-4135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health