Provider Demographics
NPI:1376090522
Name:LOVING HANDS
Entity Type:Organization
Organization Name:LOVING HANDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA/CMT
Authorized Official - Prefix:
Authorized Official - First Name:SYLVESTER
Authorized Official - Middle Name:JOSHUA
Authorized Official - Last Name:HARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-375-7080
Mailing Address - Street 1:3101 W JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32505-7651
Mailing Address - Country:US
Mailing Address - Phone:850-375-7080
Mailing Address - Fax:
Practice Address - Street 1:3101 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32505-7651
Practice Address - Country:US
Practice Address - Phone:850-375-7080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL640022Medicaid