Provider Demographics
NPI:1326765512
Name:MAJESTIC LOVING CARE
Entity Type:Organization
Organization Name:MAJESTIC LOVING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSING ASSITANT/HOME HEALTH
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHENA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-431-4414
Mailing Address - Street 1:801 INTERNATIONAL PKWY STE 500
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4763
Mailing Address - Country:US
Mailing Address - Phone:407-431-4414
Mailing Address - Fax:
Practice Address - Street 1:1217 OLD ENGLAND LOOP
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-6581
Practice Address - Country:US
Practice Address - Phone:407-431-4414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL426573OtherCNA LICENSE