MEDICARE: LOVING KARE HHS, 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	251G00000X	Community Based Hospice Care Agency	HCO00983	VA
2	251S00000X	Community/Behavioral Health Agency	HCO00983	VA
3	385H00000X	Respite Care	HCO00983	VA
4	251E00000X	Home Health Agency	HCO00983	VA

General Provider Information

NPI Number	:	1417396292
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVING KARE HHS, LLC

Provider Business Mailing Address
First Line	:	4633 PEMBROKE LAKE CIRCLE SUITE 200
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455
Country	:	US
Telephone Number	:	757-671-1387
Fax Number	:	757-671-2131

Provider Business Practice Location Address
First Line	:	4633 PEMBROKE LAKE CIR STE 200
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-6404
Country	:	US
Telephone Number	:	757-671-1387
Fax Number	:	757-671-2131

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DYTON TERRELL RENDELL
Credential	:	7576711387
Telephone Number	:	757-671-1387

Provider Enumeration Date	:	06/14/2013
Last Update Date	:	06/14/2013

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