Healthcare Provider Details

I. General information

NPI: 1316490816
Provider Name (Legal Business Name): LOVE ONE HOME HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2016
Last Update Date: 08/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 MERCANTILE LN 200-J
LARGO MD
20774-4301
US

IV. Provider business mailing address

1401 MERCANTILE LN 200-J
LARGO MD
20774-4301
US

V. Phone/Fax

Practice location:
  • Phone: 301-773-4595
  • Fax: 301-322-3824
Mailing address:
  • Phone:
  • Fax: 301-322-3824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. CHRISTINA ABANGE
Title or Position: ADMINISTRATOR
Credential:
Phone: 240-486-1388