Healthcare Provider Details

I. General information

NPI: 1578077962
Provider Name (Legal Business Name): LOVING CARE IN HOME SERVICE OF CITRUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2017
Last Update Date: 01/28/2022
Certification Date: 01/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7936 E. GULF TO LAKE HWY
INVERNESS FL
34450
US

IV. Provider business mailing address

PO BOX 2498
INVERNESS FL
34451-2498
US

V. Phone/Fax

Practice location:
  • Phone: 352-860-0885
  • Fax: 352-726-2864
Mailing address:
  • Phone: 352-860-0885
  • Fax: 352-726-2864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM D TARR
Title or Position: MANAGER
Credential:
Phone: 352-860-0885