Healthcare Provider Details

I. General information

NPI: 1700067774
Provider Name (Legal Business Name): LOVING CARE AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2007
Last Update Date: 04/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1341 ROUTE 9 UNIT 8
TOMS RIVER NJ
08755-4087
US

IV. Provider business mailing address

6 CONCOURSE PKWY STE 1100
ATLANTA GA
30328-5359
US

V. Phone/Fax

Practice location:
  • Phone: 732-270-5788
  • Fax: 732-270-2696
Mailing address:
  • Phone: 770-248-8740
  • Fax: 770-248-8192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHP0076215
License Number StateNJ

VIII. Authorized Official

Name: VICKI WHITESIDE
Title or Position: DIRECTOR REGULATORY LICENSING
Credential:
Phone: 770-248-8740