Provider Demographics
NPI:1033736095
Name:LOVING HEARTS HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:LOVING HEARTS HOME HEALTH CARE LLC
Other - Org Name:LOVING HEARTS HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:ETUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-652-0005
Mailing Address - Street 1:14046 STAHELIN AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48223-2985
Mailing Address - Country:US
Mailing Address - Phone:313-704-5431
Mailing Address - Fax:
Practice Address - Street 1:28475 GREENFIELD RD STE PMB 1187
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-3034
Practice Address - Country:US
Practice Address - Phone:313-652-0005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-25
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing Care
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care