MEDICARE: LOVING EXPRESSIONS HOME 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1659980225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVING EXPRESSIONS HOME CARE, INC.

Provider Business Mailing Address
First Line	:	12461 VETERANS MEMORIAL HWY STE 635
Second Line	:
City	:	DOUGLASVILLE
State	:	GA
Zip	:	30134-2025
Country	:	US
Telephone Number	:	770-888-7941
Fax Number	:	678-840-3750

Provider Business Practice Location Address
First Line	:	12461 VETERANS MEMORIAL HWY STE 635
Second Line	:
City	:	DOUGLASVILLE
State	:	GA
Zip	:	30134-2025
Country	:	US
Telephone Number	:	770-888-7941
Fax Number	:	678-840-3750

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SHERRIE CHRISTIAN
Credential	:	OWNER
Telephone Number	:	770-852-8906

Provider Enumeration Date	:	07/29/2020
Last Update Date	:	07/29/2020

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