Provider Demographics
NPI:1245101187
Name:BIG MOMMY HOME OF LOVE 2 LLC
Entity type:Organization
Organization Name:BIG MOMMY HOME OF LOVE 2 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GROVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-919-8330
Mailing Address - Street 1:131 N LUDLOW ST STE 210
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-1165
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:131 N LUDLOW ST STE 210
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-1165
Practice Address - Country:US
Practice Address - Phone:937-919-8330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty