Provider Demographics
NPI:1407462013
Name:LOVING HEARTS LLC
Entity Type:Organization
Organization Name:LOVING HEARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ITANZA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-925-2539
Mailing Address - Street 1:1216 E SELMA ST APT 4
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67216-4229
Mailing Address - Country:US
Mailing Address - Phone:316-925-2539
Mailing Address - Fax:
Practice Address - Street 1:2311 W WESTPORT ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-1535
Practice Address - Country:US
Practice Address - Phone:316-239-6726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care