Provider Demographics
NPI:1891409504
Name:NICOLES LOVING CARE LLC
Entity Type:Organization
Organization Name:NICOLES LOVING CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CLETESSA
Authorized Official - Middle Name:LEILA
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:234-201-3748
Mailing Address - Street 1:316 DAY ST
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-2265
Mailing Address - Country:US
Mailing Address - Phone:234-201-3748
Mailing Address - Fax:
Practice Address - Street 1:316 DAY ST
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-2265
Practice Address - Country:US
Practice Address - Phone:234-201-3748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health