Provider Demographics
NPI:1356121446
Name:ONE LOVE FAMILY CARE LLC
Entity type:Organization
Organization Name:ONE LOVE FAMILY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:LAVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-875-1153
Mailing Address - Street 1:4047 W OCOTILLO RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85019-1012
Mailing Address - Country:US
Mailing Address - Phone:602-875-1153
Mailing Address - Fax:
Practice Address - Street 1:4047 W OCOTILLO RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85019-1012
Practice Address - Country:US
Practice Address - Phone:602-875-1153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty