MEDICARE: BELOVED CARE SERVICES 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	385H00000X	Respite Care
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1356209837
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELOVED CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	1150 E LITTLE CREEK RD STE 201-4
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23518-3826
Country	:	US
Telephone Number	:	757-574-2114
Fax Number	:	757-574-2114

Provider Business Practice Location Address
First Line	:	1150 E LITTLE CREEK RD STE 201-4
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23518-3826
Country	:	US
Telephone Number	:	757-574-2114
Fax Number	:	757-574-2114

Authorized Official
Title or Position	:	OWNER
Name	:	BAMBI JOHNSON
Credential	:
Telephone Number	:	757-574-2114

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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Directions to “BELOVED CARE SERVICES LLC ” Practice Location

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