NPIMap

Organization Active NPI

The Love Lab PLLC

Doing business as Love Lab

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Peoria, AZ
National Provider Identifier
1730832668
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
THE LOVE LAB PLLC
Doing business as
Love Lab
Practice address
8551 W Cherry Hills Dr
Peoria, AZ 85345-8172
Phone
(602) 425-0030
NPI assigned
Jan 31, 2022
Last updated
Feb 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Breeanna HortonNPI 1306339395
Title
Owner
Phone
(602) 425-0030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

8551 W Cherry Hills Dr
Peoria, AZ 85345-8172

Mailing address

8551 W Cherry Hills Dr
Peoria, AZ 85345-8172
Phone (602) 425-0030

Other names 1

  • Love Lab Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220512001731 AZ Part B Supplier - Clinic/Group Practice 7113304114 Receives reassigned benefits from 7 practitioners
Practice locations: Peoria, AZ; Glendale, AZ

National Provider Directory

National Provider Directory

Locations

17505 N 79th Ave
Ste 111A
Glendale, AZ 85308
Phone (602) 425-0030

8160 W Union Hills Dr
Ste B202
Glendale, AZ 85308
Phone (602) 425-0030

12444 N 75th Ave
Peoria, AZ 85381
Phone (602) 425-0030

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1730832668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8551 W CHERRY HILLS DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458172",
            "telephone_number": "602-425-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8551 W CHERRY HILLS DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458172",
            "telephone_number": "602-425-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LOVE LAB PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "HORTON",
        "authorized_official_first_name": "BREEANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-425-0030"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Love Lab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Love Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.