MEDICARE: LOVE HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1144859190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVE HOME CARE LLC

Provider Business Mailing Address
First Line	:	419 LONGSHORE AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-3912
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	419 LONGSHORE AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-3912
Country	:	US
Telephone Number	:	267-819-6350
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TAYA FERGUSON
Credential	:
Telephone Number	:	267-819-6350

Provider Enumeration Date	:	04/02/2020
Last Update Date	:	03/03/2022

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Directions to “LOVE HOME CARE LLC ” Practice Location

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