Healthcare Provider Details

I. General information

NPI: 1093949539
Provider Name (Legal Business Name): LOVE IS QUALITY HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2009
Last Update Date: 05/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

887 THOMAS ST
MEMPHIS TN
38107-2543
US

IV. Provider business mailing address

887 THOMAS ST
MEMPHIS TN
38107-2543
US

V. Phone/Fax

Practice location:
  • Phone: 901-281-5759
  • Fax: 901-388-7151
Mailing address:
  • Phone: 901-281-5759
  • Fax: 901-388-7151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number00106545
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number00106545
License Number StateTN

VIII. Authorized Official

Name: MRS. TAMBA LASHEA JACKSON
Title or Position: CERTIFIED NURSING ASSISTANT
Credential:
Phone: 901-281-5759