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General NPI Number Information
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NPI Number | 1962385278
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Entity Type | Organization
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Legal Business Name | LOYAL HEARTS OF SERVICE LLC
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Dates
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Enumeration Date | 07/26/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 75 WASHINGTON ST UNIT 1717
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City | FAIRBURN
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State | GA
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Zip | 30213-3617
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Country | US
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Telephone | 678-374-1180
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Fax |
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Provider Business Mailing Address
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Address Line | 75 WASHINGTON ST UNIT 1717
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City | FAIRBURN
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State | GA
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Zip | 30213-3617
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Country | US
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Telephone | 678-374-1180
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Fax |
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Authorized Official
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Title or Position | DNP,MSN,PMHNP-BC
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Name | OLUWAFUNMILOLA SULAIMON
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Credential | DNP
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Telephone | 678-374-1180
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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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 | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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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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