Provider Demographics
NPI:1508097932
Name:LOVING CARE FAMILY SERVICES, LLC
Entity Type:Organization
Organization Name:LOVING CARE FAMILY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:HEATH
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-574-2444
Mailing Address - Street 1:153 CASTLEBAR CT SE
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-1766
Mailing Address - Country:US
Mailing Address - Phone:678-574-2444
Mailing Address - Fax:678-574-2443
Practice Address - Street 1:153 CASTLEBAR CT SE
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-1766
Practice Address - Country:US
Practice Address - Phone:678-574-2444
Practice Address - Fax:678-574-2443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033R0106251J00000X, 251S00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA181121028BMedicaid
GA181121028CMedicaid