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General NPI Number Information
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NPI Number | 1871688150
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Entity Type | Organization
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Legal Business Name | M&B LOVING HOME CARE
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/17/2013
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Provider Practice Location Address
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Address Line | 3793 SHEARIN RD
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City | WHITAKERS
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State | NC
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Zip | 27891-9489
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Country | US
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Telephone | 252-907-1759
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 936
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City | HOLLISTER
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State | NC
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Zip | 27844-0936
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLEPROPRIETOR
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Name | MARY BULLUCK
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Credential |
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Telephone | 252-907-1759
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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 | HC3055
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | HC3055
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License Number State | NC
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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 | HC3055
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License Number State | NC
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