Healthcare Provider Details

I. General information

NPI: 1770396129
Provider Name (Legal Business Name): LOVE IN ACTION HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2025
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4710 GREENCASTLE RD
LAUREL MD
20707-3142
US

IV. Provider business mailing address

4710 GREENCASTLE RD
LAUREL MD
20707-3142
US

V. Phone/Fax

Practice location:
  • Phone: 571-405-8992
  • Fax:
Mailing address:
  • Phone: 571-405-8992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: YERUKNESH ADMASSU ENDALAMAW
Title or Position: ADMINSTRATOR
Credential:
Phone: 571-405-8992