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General NPI Number Information
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NPI Number | 1538469853
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Entity Type | Organization
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Legal Business Name | LOVING CARE III, LLC
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Dates
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Enumeration Date | 11/02/2010
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Last Update Date | 11/02/2010
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Provider Practice Location Address
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Address Line | 395 MAIN ST
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City | ORANGE
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State | NJ
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Zip | 07050-2774
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Country | US
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Telephone | 973-678-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 11 SALVATORE DR
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5898
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Country | US
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Telephone | 732-670-2039
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Fax |
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Authorized Official
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Title or Position | CASE MANAGER/CARE COORDINATOR
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Name | MRS. TEMEKIA DONALD
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Credential |
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Telephone | 732-670-2039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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