Healthcare Provider Details

I. General information

NPI: 1558232462
Provider Name (Legal Business Name): LOVE ENTIRELY LLC SENIOR SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 N WISNER ST
JACKSON MI
49202-3167
US

IV. Provider business mailing address

825 N WISNER ST
JACKSON MI
49202-3167
US

V. Phone/Fax

Practice location:
  • Phone: 517-392-3704
  • Fax:
Mailing address:
  • Phone: 517-392-3704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name: SIERRA GANT
Title or Position: OWNER
Credential: LLMSW
Phone: 517-392-3704