Provider Demographics
NPI:1689870040
Name:LOVE AND CARE FAMILY CARE HOME
Entity Type:Organization
Organization Name:LOVE AND CARE FAMILY CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOVIETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEATHERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-361-4206
Mailing Address - Street 1:4712 BAY POINT DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-9415
Mailing Address - Country:US
Mailing Address - Phone:919-361-4206
Mailing Address - Fax:
Practice Address - Street 1:217 E LAWSON ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3143
Practice Address - Country:US
Practice Address - Phone:919-361-4206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-032-0783104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness