Healthcare Provider Details

I. General information

NPI: 1689286825
Provider Name (Legal Business Name): LOVING&CARING HEARTS HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2020
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 THOMAS DR
LAUREL MS
39440-1079
US

IV. Provider business mailing address

PO BOX 4039
LAUREL MS
39441-4039
US

V. Phone/Fax

Practice location:
  • Phone: 601-498-1509
  • Fax:
Mailing address:
  • Phone: 601-498-1509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: QUENZADA JEFFERSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 601-498-1509