Provider Demographics
NPI:1073913034
Name:LOVE & CARE RESIDENTIAL SERVICES LLC
Entity Type:Organization
Organization Name:LOVE & CARE RESIDENTIAL SERVICES LLC
Other - Org Name:PORTER HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:MINTHREE
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-518-6052
Mailing Address - Street 1:4325 BLUEBONNET CT
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-2660
Mailing Address - Country:US
Mailing Address - Phone:325-518-6052
Mailing Address - Fax:
Practice Address - Street 1:4325 BLUEBONNET CT
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-2660
Practice Address - Country:US
Practice Address - Phone:325-518-6052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services