MEDICARE: THE LOVING CARE HOME OF THE PALM BEACHES

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	310400000X	Assisted Living Facility	12560	FL

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	:	1831605211
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE LOVING CARE HOME OF THE PALM BEACHES

Provider Business Mailing Address
First Line	:	12483 TANGERINE BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33412-2041
Country	:	US
Telephone Number	:	561-847-4318
Fax Number	:

Provider Business Practice Location Address
First Line	:	12483 TANGERINE BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33412-2041
Country	:	US
Telephone Number	:	561-847-4318
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JULIA BLANCHARD
Credential	:
Telephone Number	:	561-983-7381

Provider Enumeration Date	:	12/20/2017
Last Update Date	:	09/26/2022

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