MEDICARE: LOVING HEARTS HOMECARE SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	376K00000X	Nurse's Aide	MS
2	164W00000X	Licensed Practical Nurse	MS
3	163W00000X	Registered Nurse	MS
4	3747P1801X	Personal Care Attendant	MS
5	376J00000X	Homemaker	MS
6	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1336670694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVING HEARTS HOMECARE SERVICES LLC

Provider Business Mailing Address
First Line	:	1737 BEULAH AVE
Second Line	:
City	:	TYLERTOWN
State	:	MS
Zip	:	39667-2421
Country	:	US
Telephone Number	:	601-996-9274
Fax Number	:

Provider Business Practice Location Address
First Line	:	7288 FRANCIS DR
Second Line	:
City	:	GAUTIER
State	:	MS
Zip	:	39553-2869
Country	:	US
Telephone Number	:	601-996-9274
Fax Number	:	228-233-3172

Authorized Official
Title or Position	:	OWNER
Name	:	DEMETRIC D MAGEE
Credential	:
Telephone Number	:	228-215-1672

Provider Enumeration Date	:	03/27/2017
Last Update Date	:	05/31/2026

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