Provider Demographics
NPI:1194851089
Name:LOVING CARE AGENCY, INC
Entity Type:Organization
Organization Name:LOVING CARE AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:CREAMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-403-9310
Mailing Address - Street 1:611 ROUTE 46 WEST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HASBROUCK HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604-3118
Mailing Address - Country:US
Mailing Address - Phone:201-403-9300
Mailing Address - Fax:201-403-9262
Practice Address - Street 1:629 E WOOD ST
Practice Address - Street 2:SUITE 104
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-3730
Practice Address - Country:US
Practice Address - Phone:856-690-5701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0076210251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01106201Medicaid