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Organization

LOVE GARDEN, LLC

Active
Other names
Love Garden Healthcare Agency
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CLEMENT C IHEANACHO PH.D. (PRESIDENT)
(336) 988-2964
Entity
Organization

Contact information

Practice address
419 BENNETT ST, GREENSBORO, NC 27406-1847
(336) 988-2964
(336) 790-8555
Mailing address
419 BENNETT ST, GREENSBORO, NC 27406-1847
(336) 988-2964
(336) 790-8555

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC3594
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MH-041-783
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
061380
FACILITY ID:
NC
01
061400
FACILITY ID:
NC
05
3418269
NC
05
6601648
NC
05
6604006
NC
05
8301659
NC
05
8301659B
NC
05
8301748
NC
05
8301748G
NC
Enumeration date
12/20/2006
Last updated
09/20/2007
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