Provider Demographics
NPI:1164047908
Name:LOVING HEARTS GROUP HOME INC
Entity Type:Organization
Organization Name:LOVING HEARTS GROUP HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIARA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ROSADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-673-7165
Mailing Address - Street 1:1099 ZINNIA RD
Mailing Address - Street 2:
Mailing Address - City:LABELLE
Mailing Address - State:FL
Mailing Address - Zip Code:33935-9795
Mailing Address - Country:US
Mailing Address - Phone:863-673-7165
Mailing Address - Fax:
Practice Address - Street 1:1099 ZINNIA RD
Practice Address - Street 2:
Practice Address - City:LABELLE
Practice Address - State:FL
Practice Address - Zip Code:33935-9795
Practice Address - Country:US
Practice Address - Phone:863-673-7165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities