Healthcare Provider Details

I. General information

NPI: 1033850268
Provider Name (Legal Business Name): LOVEWATCH TLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2022
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9020 LORTON STATION BLVD STE 114
LORTON VA
22079-4750
US

IV. Provider business mailing address

7676 WOLFORD WAY
LORTON VA
22079-1740
US

V. Phone/Fax

Practice location:
  • Phone: 443-857-1095
  • Fax:
Mailing address:
  • Phone:
  • 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 Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: NIKKIA BIVENS
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 571-574-2300