MEDICARE: LUV THY NEIGHBOR

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	:	1164836219
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUV THY NEIGHBOR

Provider Business Mailing Address
First Line	:	PO BOX 166
Second Line	:
City	:	DUNDEE
State	:	FL
Zip	:	33838
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	277 JEFFERSON DR
Second Line	:
City	:	HAINES CITY
State	:	FL
Zip	:	33844-7730
Country	:	US
Telephone Number	:	863-236-4294
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TRACIE MOCKS
Credential	:
Telephone Number	:	863-236-4294

Provider Enumeration Date	:	06/17/2014
Last Update Date	:	06/17/2014

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