Provider Demographics
NPI:1295584050
Name:FAVOR LOVING CARE
Entity type:Organization
Organization Name:FAVOR LOVING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE / RN, BSN, MSN, DNP
Authorized Official - Prefix:DR
Authorized Official - First Name:JEMIMA
Authorized Official - Middle Name:FRIMPONG
Authorized Official - Last Name:KODUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-626-3286
Mailing Address - Street 1:1117 FUTURITY ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-2358
Mailing Address - Country:US
Mailing Address - Phone:240-626-3286
Mailing Address - Fax:
Practice Address - Street 1:14502 GREENVIEW DR STE 427
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-3287
Practice Address - Country:US
Practice Address - Phone:240-626-3286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty