Healthcare Provider Details

I. General information

NPI: 1376821223
Provider Name (Legal Business Name): LOVING CARE DAYCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2011
Last Update Date: 07/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 E FLOYCE ST
RULEVILLE MS
38771-3915
US

IV. Provider business mailing address

107 E FLOYCE ST
RULEVILLE MS
38771-3915
US

V. Phone/Fax

Practice location:
  • Phone: 662-719-3605
  • Fax: 662-756-9979
Mailing address:
  • Phone: 662-719-3605
  • Fax: 662-756-9979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. SANDRA ELIZABETH LIVINGSTON
Title or Position: OWNE
Credential: CEO
Phone: 662-719-3605