Provider Demographics
NPI:1366846404
Name:THE LOVING HOME,INC. #6
Entity Type:Organization
Organization Name:THE LOVING HOME,INC. #6
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DESMOND
Authorized Official - Middle Name:ONYE
Authorized Official - Last Name:OKORIEOCH
Authorized Official - Suffix:
Authorized Official - Credentials:BS,MBA
Authorized Official - Phone:910-624-0844
Mailing Address - Street 1:1903 BRIDGER ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-3913
Mailing Address - Country:US
Mailing Address - Phone:910-884-3896
Mailing Address - Fax:910-484-0629
Practice Address - Street 1:1903 BRIDGER ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-3913
Practice Address - Country:US
Practice Address - Phone:910-884-3896
Practice Address - Fax:910-484-0629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408341Medicaid