Provider Demographics
NPI:1528405115
Name:LOVING HEARTS HOME CARE INC
Entity Type:Organization
Organization Name:LOVING HEARTS HOME CARE INC
Other - Org Name:LOVING HEARTS HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KARLE
Authorized Official - Middle Name:B
Authorized Official - Last Name:KINCAID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-842-2228
Mailing Address - Street 1:10411 CORPORATE DR STE 102A
Mailing Address - Street 2:
Mailing Address - City:PLEASANT PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53158-1619
Mailing Address - Country:US
Mailing Address - Phone:262-842-2228
Mailing Address - Fax:262-355-0444
Practice Address - Street 1:10411 CORPORATE DR STE 102A
Practice Address - Street 2:
Practice Address - City:PLEASANT PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53158-1619
Practice Address - Country:US
Practice Address - Phone:262-842-2228
Practice Address - Fax:262-355-0444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-23
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100023466Medicaid