Provider Demographics
NPI:1164277596
Name:LOVING CARE ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:LOVING CARE ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:TATE
Authorized Official - Last Name:MCCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-722-2000
Mailing Address - Street 1:210 FAIRLANE DR
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:38485-2419
Mailing Address - Country:US
Mailing Address - Phone:931-722-2000
Mailing Address - Fax:931-722-6891
Practice Address - Street 1:210 FAIRLANE DR
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:TN
Practice Address - Zip Code:38485-2419
Practice Address - Country:US
Practice Address - Phone:931-722-2000
Practice Address - Fax:931-722-6891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility