Provider Demographics
NPI:1861829574
Name:TERRI'S LOVING CARE LLC
Entity Type:Organization
Organization Name:TERRI'S LOVING CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIZZIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-287-4655
Mailing Address - Street 1:414 TREE SWALLOW DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-9000
Mailing Address - Country:US
Mailing Address - Phone:850-287-4655
Mailing Address - Fax:850-912-4800
Practice Address - Street 1:414 TREE SWALLOW DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-9000
Practice Address - Country:US
Practice Address - Phone:850-287-4655
Practice Address - Fax:850-912-4800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLS-2208251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007394800Medicaid