Healthcare Provider Details

I. General information

NPI: 1689043440
Provider Name (Legal Business Name): JENKINS LOVIN CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2015
Last Update Date: 09/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 BLUEBERRY CT
EDGEWOOD MD
21040-3538
US

IV. Provider business mailing address

411 BLUEBERRY CT
EDGEWOOD MD
21040-3538
US

V. Phone/Fax

Practice location:
  • Phone: 443-621-1840
  • Fax: 410-676-6375
Mailing address:
  • Phone: 443-621-1840
  • Fax: 410-676-6375

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 Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. SANDRA JENKINS
Title or Position: OWNER
Credential:
Phone: 443-621-1840