MEDICARE: LOVING FAMILY HOME HEALTH 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	:	1487406468
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVING FAMILY HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	8909 BURTON AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63114-4823
Country	:	US
Telephone Number	:	314-452-9744
Fax Number	:

Provider Business Practice Location Address
First Line	:	8909 BURTON AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63114-4823
Country	:	US
Telephone Number	:	314-452-9744
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	WAKEATHA DUFF
Credential	:
Telephone Number	:	314-452-9744

Provider Enumeration Date	:	04/03/2024
Last Update Date	:	04/03/2024

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