Organization
LOVING LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALONDA OWENS (PRESIDENT)
(910) 977-4610
Entity
Organization
Contact information
Practice address
510 CANDLEBERRY CT, FAYETTEVILLE, NC 28301-7901
(910) 977-4610
Mailing address
510 CANDLEBERRY CT, FAYETTEVILLE, NC 28301-7901
(910) 977-4610
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
HC4740
NC
Other
Enumeration date
04/24/2015
Last updated
04/24/2015
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