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General NPI Number Information
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NPI Number | 1053730135
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Entity Type | Organization
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Legal Business Name | CARING & LOVING HEARTS LLC
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 04/15/2014
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Provider Practice Location Address
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Address Line | 17399 10TH ST
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City | GULFPORT
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State | MS
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Zip | 39503-7922
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Country | US
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Telephone | 228-284-8487
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Fax |
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Provider Business Mailing Address
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Address Line | 17399 10TH ST
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City | GULFPORT
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State | MS
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Zip | 39503-7922
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Country | US
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Telephone | 228-284-8487
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Fax |
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Authorized Official
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Title or Position | RN
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Name | MS. NUJUANA RILEY
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Credential | RN
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Telephone | 228-284-8487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | R877585
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License Number State | MS
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