Healthcare Provider Details

I. General information

NPI: 1598448243
Provider Name (Legal Business Name): LOVING ANGEL HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 WASHINGTONIA DR
LAREDO TX
78045-5131
US

IV. Provider business mailing address

105 WASHINGTONIA DR
LAREDO TX
78045-5131
US

V. Phone/Fax

Practice location:
  • Phone: 956-251-5887
  • Fax:
Mailing address:
  • Phone: 956-441-3067
  • Fax: 956-602-1157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: JACQUELINE CARETTA
Title or Position: CEO
Credential: ALTERNATE ADM.
Phone: 956-441-3067