Healthcare Provider Details

I. General information

NPI: 1285266296
Provider Name (Legal Business Name): LOVEBIRD HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2020
Last Update Date: 03/02/2022
Certification Date: 03/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 LINCOLN HWY STE 200
MATTESON IL
60443-3084
US

IV. Provider business mailing address

1921 RIDGE RD UNIT 1356
HOMEWOOD IL
60430-4662
US

V. Phone/Fax

Practice location:
  • Phone: 708-580-6956
  • Fax: 866-709-7003
Mailing address:
  • Phone: 708-580-6956
  • Fax: 866-709-7003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: GLORIA BAKER
Title or Position: OWNER
Credential:
Phone: 708-269-5311