Provider Demographics
NPI:1457680571
Name:LOVING & GENTLE CARE HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:LOVING & GENTLE CARE HOME HEALTH SERVICES
Other - Org Name:HEAVENLY HANDS HOME CARE SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHALUNDRA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BRUTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-288-2617
Mailing Address - Street 1:2221 AUGUSTA STREET
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605
Mailing Address - Country:US
Mailing Address - Phone:864-288-2617
Mailing Address - Fax:866-681-5290
Practice Address - Street 1:2221 AUGUSTA ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-1766
Practice Address - Country:US
Practice Address - Phone:864-288-2617
Practice Address - Fax:866-681-5290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-19
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX0994Medicaid