MEDICARE: LOVIEROSE HEALTHCARE 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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1831050715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVIEROSE HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	811 JUNIPER ST NE APT 1517
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30308-2162
Country	:	US
Telephone Number	:	470-985-7900
Fax Number	:

Provider Business Practice Location Address
First Line	:	811 JUNIPER ST NE APT 1517
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30308-2162
Country	:	US
Telephone Number	:	470-985-7900
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TRACEY WASHINGTON
Credential	:
Telephone Number	:	470-985-7900

Provider Enumeration Date	:	11/20/2025
Last Update Date	:	11/20/2025

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