Provider Demographics
NPI:1578212775
Name:LOVING HEARTS NORTHSHORE
Entity Type:Organization
Organization Name:LOVING HEARTS NORTHSHORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:DURAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-821-5220
Mailing Address - Street 1:10040 I 10 SERVICE RD STE B
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-2701
Mailing Address - Country:US
Mailing Address - Phone:504-821-8220
Mailing Address - Fax:
Practice Address - Street 1:202 VILLAGE CIR STE 2
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-5418
Practice Address - Country:US
Practice Address - Phone:985-331-8070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-23
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2593391Medicaid