Provider Demographics
NPI: | 1881024511 |
---|---|
Name: | LOVING CARE FOSTER HOMES |
Entity Type: | Organization |
Organization Name: | LOVING CARE FOSTER HOMES |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JOYCE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SIHOTANG |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | RN |
Authorized Official - Phone: | 269-471-1913 |
Mailing Address - Street 1: | 8228 KEPHART LN |
Mailing Address - Street 2: | |
Mailing Address - City: | BERRIEN SPRINGS |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 49103-9573 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 269-471-2128 |
Mailing Address - Fax: | 269-471-1913 |
Practice Address - Street 1: | 3611 E. SNOW RD. |
Practice Address - Street 2: | |
Practice Address - City: | BERRIEN SPRINGS |
Practice Address - State: | MI |
Practice Address - Zip Code: | 49103 |
Practice Address - Country: | US |
Practice Address - Phone: | 269-471-2128 |
Practice Address - Fax: | 269-471-1913 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-11-15 |
Last Update Date: | 2013-11-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MI | AM 110315886 | 310400000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility |