Healthcare Provider Details

I. General information

NPI: 1043012354
Provider Name (Legal Business Name): LOYALTY AND LOVE HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 MORNING DEW DR
CONCORD NC
28025-9048
US

IV. Provider business mailing address

363 MORNING DEW DR
CONCORD NC
28025-9048
US

V. Phone/Fax

Practice location:
  • Phone: 912-601-1365
  • Fax: 912-601-1365
Mailing address:
  • Phone: 912-601-1365
  • Fax: 912-601-1365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. CA'DEIDRE DIONNE WALKER
Title or Position: AGENCY DIRECTOR
Credential: RN
Phone: 912-601-1365