Healthcare Provider Details

I. General information

NPI: 1699553461
Provider Name (Legal Business Name): SARA LOVING CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2023
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1053 PERRY SWITCH RD
JACKSON TN
38301-9561
US

IV. Provider business mailing address

9407 CANABRIDGE DR
LAKELAND TN
38002-4179
US

V. Phone/Fax

Practice location:
  • Phone: 731-935-9569
  • Fax:
Mailing address:
  • Phone: 731-935-9569
  • Fax:

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 Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ALI DANIAL ABUJABER
Title or Position: GENERAL MANAGER
Credential:
Phone: 731-935-9569