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General NPI Number Information
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NPI Number | 1093275349
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Entity Type | Organization
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Legal Business Name | LOVING HEART ASSISTED LIVING
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Dates
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Enumeration Date | 03/22/2019
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Last Update Date | 03/22/2019
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Provider Practice Location Address
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Address Line | 9301 MYRTLE AVENE
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City | BOWIE
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State | MD
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Zip | 20720-3202
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Country | US
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Telephone | 800-548-5060
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Fax | 301-304-1908
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Provider Business Mailing Address
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Address Line | 1783 FOREST DR STE 106
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City | ANNAPOLIS
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State | MD
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Zip | 21401-4229
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Country | US
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Telephone | 410-772-4464
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Fax | 301-304-1908
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Authorized Official
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Title or Position | CEO/ MEMBER
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Name | CORIE JOHNSON
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Credential |
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Telephone | 410-772-4464
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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