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General NPI Number Information
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NPI Number | 1104226786
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Entity Type | Organization
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Legal Business Name | LOVING HEART HOME CARE
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Dates
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Enumeration Date | 09/02/2014
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Last Update Date | 03/11/2024
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Provider Practice Location Address
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Address Line | 12875 ARCHDALE
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City | DETROIT
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State | MI
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Zip | 48227
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Country | US
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Telephone | 248-228-0075
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Fax |
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Provider Business Mailing Address
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Address Line | 12875 ARCHDALE ST
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City | DETROIT
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State | MI
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Zip | 48227-1265
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Country | US
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Telephone | 248-228-0075
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Fax |
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Authorized Official
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Title or Position | HOME CARE ASSISTANT
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Name | MS. DESHONNA LAFAY MARTIN I
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Credential | MA,CNA
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Telephone | 248-228-0075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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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 | 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 #3
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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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