MEDICARE: LOVING HANDS ADULT DAY CARE, INC.

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	261QA0600X	Adult Day Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497055537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVING HANDS ADULT DAY CARE, INC.

Provider Business Mailing Address
First Line	:	614 E POPLAR
Second Line	:
City	:	KOKOMO
State	:	IN
Zip	:	46902-2271
Country	:	US
Telephone Number	:	765-455-2300
Fax Number	:	765-455-4035

Provider Business Practice Location Address
First Line	:	614 E BOULEVARD
Second Line	:
City	:	KOKOMO
State	:	IN
Zip	:	46902-2271
Country	:	US
Telephone Number	:	765-455-2300
Fax Number	:	765-455-4035

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. CHARLESZETTA LEWIS LEWIS
Credential	:
Telephone Number	:	765-455-2300

Provider Enumeration Date	:	10/22/2010
Last Update Date	:	10/22/2010

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