Provider Demographics
NPI:1336652510
Name:GREATER LOVE HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:GREATER LOVE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUNDTREE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:609-221-5261
Mailing Address - Street 1:1 CLEARBROOK LN
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-3321
Mailing Address - Country:US
Mailing Address - Phone:609-221-5261
Mailing Address - Fax:
Practice Address - Street 1:2 RIVERSIDE DR STE 503
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1019
Practice Address - Country:US
Practice Address - Phone:856-335-5683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-10
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health