| Love Lab | |
|
8551 W Cherry Hills Dr Peoria AZ 85345-8172 | |
| (602) 425-0030 | |
| Not Available |
| Full Name | Love Lab |
|---|---|
| Speciality | Clinic/Center |
| Location | 8551 W Cherry Hills Dr, Peoria, Arizona |
| Authorized Official Name and Position | Breeanna Horton (OWNER) |
| Authorized Official Contact | 6024250030 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Love Lab 8551 W Cherry Hills Dr Peoria AZ 85345-8172 Ph: (602) 425-0030 | Love Lab 8551 W Cherry Hills Dr Peoria AZ 85345-8172 Ph: (602) 425-0030 |
| NPI Number | 1730832668 |
|---|---|
| Provider Enumeration Date | 01/31/2022 |
| Last Update Date | 02/08/2022 |
| Certification Date | 02/08/2022 |
| Medicare PECOS PAC ID | 7113304114 |
|---|---|
| Medicare Enrollment ID | O20220512001731 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730832668 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Breeanna Horton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306339395 PECOS PAC ID: 3577967082 Enrollment ID: I20220512001715 |
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