Provider Demographics
NPI:1821796723
Name:LOVING HANDS EXTENDED HOME SERVICES LLC
Entity Type:Organization
Organization Name:LOVING HANDS EXTENDED HOME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:BOZEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PEGGY BOZEMAN, RNC
Authorized Official - Phone:229-434-1372
Mailing Address - Street 1:1906 DAWSON RD STE 2
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-3306
Mailing Address - Country:US
Mailing Address - Phone:229-434-1372
Mailing Address - Fax:229-434-0382
Practice Address - Street 1:1906 DAWSON RD STE 2
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-3306
Practice Address - Country:US
Practice Address - Phone:229-434-1372
Practice Address - Fax:229-434-0382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care