MEDICARE: LOVING CARE IN HOME HEALTH SERVICES 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1821749318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVING CARE IN HOME HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	10729 N 19TH AVE STE A
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4926
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10729 N 19TH AVE STE A
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4926
Country	:	US
Telephone Number	:	702-903-5648
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DANIELLE CARTER
Credential	:
Telephone Number	:	702-903-5648

Provider Enumeration Date	:	01/16/2022
Last Update Date	:	01/18/2022

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