Provider Demographics
NPI:1740837236
Name:LOVING JEWELS HOMEHEALTH CARE LLC
Entity type:Organization
Organization Name:LOVING JEWELS HOMEHEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-401-7631
Mailing Address - Street 1:10201 LILAC AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63137-3424
Mailing Address - Country:US
Mailing Address - Phone:314-401-7631
Mailing Address - Fax:
Practice Address - Street 1:10201 LILAC AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63137-3424
Practice Address - Country:US
Practice Address - Phone:314-401-7631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health