=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750548301
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LOVING CARE PERSONAL CARE HOME
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/21/2008
-----------------------------------------------------
Last Update Date | 10/27/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3910 NORTH FWY # L
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77022-4302
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-691-7437
-----------------------------------------------------
Fax | 713-699-1572
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3910 NORTH FWY # L
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77022-4302
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-691-7437
-----------------------------------------------------
Fax | 713-699-1572
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MR. TORRON MINGO
-----------------------------------------------------
Credential | M.S.,
-----------------------------------------------------
Telephone | 713-691-7437
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QA0600X
-----------------------------------------------------
Taxonomy Name | Adult Day Care Clinic/Center
-----------------------------------------------------
License Number | 050664
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------