MEDICARE: GOD'S LOVE HOME CARE LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	251E00000X	Home Health Agency
3	251F00000X	Home Infusion Agency
4	251S00000X	Community/Behavioral Health Agency
5	253Z00000X	In Home Supportive Care Agency
6	376J00000X	Homemaker
7	376K00000X	Nurse's Aide
8	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1437607843
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOD'S LOVE HOME CARE LLC.

Provider Business Mailing Address
First Line	:	122 E MAIN ST # 305
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33801-4655
Country	:	US
Telephone Number	:	800-207-6199
Fax Number	:

Provider Business Practice Location Address
First Line	:	122 E MAIN ST # 305
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33801-4655
Country	:	US
Telephone Number	:	800-207-6199
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CRYSTAL RICHELLE JOHNSON-OPOKU
Credential	:	MSN, RN
Telephone Number	:	863-397-6322

Provider Enumeration Date	:	09/14/2016
Last Update Date	:	11/02/2023

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