Provider Demographics
NPI:1871224766
Name:LOVING CARE PRIVATE HOME SERVICES LLC
Entity Type:Organization
Organization Name:LOVING CARE PRIVATE HOME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:YARINA
Authorized Official - Last Name:TAVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-506-2759
Mailing Address - Street 1:145 BAYSHORE CT
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-5025
Mailing Address - Country:US
Mailing Address - Phone:813-506-2759
Mailing Address - Fax:
Practice Address - Street 1:145 BAYSHORE CT
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-5025
Practice Address - Country:US
Practice Address - Phone:813-506-2759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty