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General NPI Number Information
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NPI Number | 1679288807
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Entity Type | Organization
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Legal Business Name | LOVE IN ACTION (LIA) HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 01/23/2023
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 1127 QUEENSDOWN WAY
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City | FORNEY
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State | TX
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Zip | 75126-3579
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Country | US
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Telephone | 336-471-3394
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Fax |
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Provider Business Mailing Address
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Address Line | 1127 QUEENSDOWN WAY
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City | FORNEY
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State | TX
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Zip | 75126-3579
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Country | US
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Telephone | 336-471-3394
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Fax |
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | SAMMY O AYODELE
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Credential | RN
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Telephone | 336-471-3394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #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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