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General NPI Number Information
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NPI Number | 1053642702
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Entity Type | Organization
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Legal Business Name | LOVE CARE
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Dates
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Enumeration Date | 01/20/2010
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Last Update Date | 01/20/2010
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Provider Practice Location Address
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Address Line | 100 W 5TH ST
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City | HOLTON
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State | KS
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Zip | 66436-1705
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Country | US
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Telephone | 785-362-6101
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Fax | 785-362-6100
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Provider Business Mailing Address
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Address Line | 100 W 5TH ST PO BOX 1021
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City | HOLTON
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State | KS
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Zip | 66436-1705
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Country | US
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Telephone | 785-362-6101
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Fax | 785-362-6100
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SUE OLSON
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Credential | R.N.
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Telephone | 785-362-6101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | A043002
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License Number State | KS
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