MEDICARE: ORGANIC LOVE & 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

General Provider Information

NPI Number	:	1144902743
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORGANIC LOVE & CARE LLC

Provider Business Mailing Address
First Line	:	1516 WESTWOOD DR
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31721-2939
Country	:	US
Telephone Number	:	229-381-5112
Fax Number	:

Provider Business Practice Location Address
First Line	:	1516 WESTWOOD DR
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31721-2939
Country	:	US
Telephone Number	:	229-381-5112
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TIFFANY CHILDS
Credential	:
Telephone Number	:	229-381-5112

Provider Enumeration Date	:	08/02/2023
Last Update Date	:	08/02/2023

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Directions to “ORGANIC LOVE & CARE LLC ” Practice Location

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