Healthcare Provider Details

I. General information

NPI: 1972082147
Provider Name (Legal Business Name): LOTS OF LOVE ASSISTED LIVING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2018
Last Update Date: 08/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

454 ANDERSON RD S
ROCK HILL SC
29730-3392
US

IV. Provider business mailing address

6039 HANNA CT
CHARLOTTE NC
28212-2187
US

V. Phone/Fax

Practice location:
  • Phone: 704-963-8313
  • Fax:
Mailing address:
  • Phone: 704-963-8313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: JULIAN TINGLE
Title or Position: DIRECTOR
Credential:
Phone: 704-963-8313