Provider Demographics
NPI:1619037314
Name:LOVE'S PERSONAL CARE FACILITIES INC
Entity Type:Organization
Organization Name:LOVE'S PERSONAL CARE FACILITIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:LOVETT
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:706-793-1949
Mailing Address - Street 1:2366 DUBLIN DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-4021
Mailing Address - Country:US
Mailing Address - Phone:706-793-1949
Mailing Address - Fax:706-796-0403
Practice Address - Street 1:2366 DUBLIN DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-4021
Practice Address - Country:US
Practice Address - Phone:706-793-1949
Practice Address - Fax:706-796-0403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2006#002837305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00798124AMedicaid
GA00374448AMedicaid
GA00374448BMedicaid
GA00798124BMedicaid