Provider Demographics
NPI:1164002739
Name:PINES LOVING HOME HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:PINES LOVING HOME HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TYNISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-839-6733
Mailing Address - Street 1:522 S INDEPENDENCE BLVD STE 102C
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1149
Mailing Address - Country:US
Mailing Address - Phone:757-937-3235
Mailing Address - Fax:757-937-3235
Practice Address - Street 1:522 S INDEPENDENCE BLVD STE 102C
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1149
Practice Address - Country:US
Practice Address - Phone:757-937-3235
Practice Address - Fax:757-937-3235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7870851OtherNOTARY