Provider Demographics
NPI:1629176979
Name:LOVING HEARTS HOME CARE, LLC
Entity Type:Organization
Organization Name:LOVING HEARTS HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:JEFFERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-219-7420
Mailing Address - Street 1:3015 FOREST GROVE AVE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-4042
Mailing Address - Country:US
Mailing Address - Phone:937-274-2181
Mailing Address - Fax:937-274-8781
Practice Address - Street 1:3015 FOREST GROVE AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-4042
Practice Address - Country:US
Practice Address - Phone:937-274-2181
Practice Address - Fax:937-274-8781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1620133251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health