MEDICARE: LOVING HANDS 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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
3	347C00000X	Private Vehicle
4	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1487262259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVING HANDS HOME CARE LLC

Provider Business Mailing Address
First Line	:	12414 GILA RIVER DR
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93312-5740
Country	:	US
Telephone Number	:	661-501-0165
Fax Number	:

Provider Business Practice Location Address
First Line	:	12414 GILA RIVER DR
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93312-5740
Country	:	US
Telephone Number	:	661-501-0165
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	SCYOTRIA WILLIAMS-WILSON
Credential	:
Telephone Number	:	661-501-0165

Provider Enumeration Date	:	07/17/2020
Last Update Date	:	07/17/2020

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