Healthcare Provider Details

I. General information

NPI: 1346619640
Provider Name (Legal Business Name): LOVE AND COMPANION IN-HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2015
Last Update Date: 09/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9117 AUTOVILLE DR
COLLEGE PARK MD
20740-1303
US

IV. Provider business mailing address

PO BOX 737
COLLEGE PARK MD
20741-0737
US

V. Phone/Fax

Practice location:
  • Phone: 240-581-2523
  • Fax: 855-581-6744
Mailing address:
  • Phone: 240-581-2523
  • Fax: 855-581-6744

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateMD

VIII. Authorized Official

Name: MRS. MARY JOHNSON CAMPBELL
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 240-581-2523