Healthcare Provider Details

I. General information

NPI: 1740533652
Provider Name (Legal Business Name): LOVING CARE LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 10/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 NW 9TH AVE
GAINESVILLE FL
32601-4943
US

IV. Provider business mailing address

1205 NW 9TH AVE
GAINESVILLE FL
32601-4943
US

V. Phone/Fax

Practice location:
  • Phone: 858-999-5258
  • Fax:
Mailing address:
  • Phone: 858-999-5258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberAL12003
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberAL12003
License Number StateFL

VIII. Authorized Official

Name: FABIO CAMPANARO
Title or Position: MANAGING MEMBER
Credential:
Phone: 858-999-5258