Healthcare Provider Details

I. General information

NPI: 1871400341
Provider Name (Legal Business Name): GENUINE LOVE IHC PROVIDERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

376 SONIA DRIVE COLUMBUS MS 39702
COLUMBUS MS
66284-8993
US

IV. Provider business mailing address

376 SONIA DRIVE COLUMBUS MS 39702
COLUMBUS MS
66284-8993
US

V. Phone/Fax

Practice location:
  • Phone: 662-848-9937
  • Fax: 662-848-9937
Mailing address:
  • Phone: 662-848-9937
  • Fax: 662-848-9937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. PRECIOUS N CRADDIETH
Title or Position: OWNER
Credential: CRADDIETH
Phone: 662-848-9937