MEDICARE: LOVELY 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1205524949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVELY HOME CARE LLC

Provider Business Mailing Address
First Line	:	1710 COX AVE
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27801-3067
Country	:	US
Telephone Number	:	252-266-8493
Fax Number	:

Provider Business Practice Location Address
First Line	:	1710 COX AVE
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27801-3067
Country	:	US
Telephone Number	:	252-266-8493
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LOUISE L WILLIAMS
Credential	:
Telephone Number	:	252-266-8493

Provider Enumeration Date	:	05/01/2023
Last Update Date	:	05/01/2023

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Directions to “LOVELY HOME CARE LLC ” Practice Location

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