Healthcare Provider Details

I. General information

NPI: 1114104916
Provider Name (Legal Business Name): LOVING CARE AGENCY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2008
Last Update Date: 05/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 S MAIN ST
TAYLOR PA
18517-2106
US

IV. Provider business mailing address

611 ROUTE 46 WEST SUITE 200
HASBROUCK HEIGHTS NJ
07604-3118
US

V. Phone/Fax

Practice location:
  • Phone: 570-562-2925
  • Fax: 570-562-7659
Mailing address:
  • Phone: 201-403-9300
  • Fax: 201-403-9262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number03240501
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. ROBERT F. CREAMER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 201-403-9310