Provider Demographics
NPI:1922577063
Name:LOVING HANDS CAREGIVER
Entity Type:Organization
Organization Name:LOVING HANDS CAREGIVER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEPRIEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-888-2362
Mailing Address - Street 1:1542 CORA DR
Mailing Address - Street 2:
Mailing Address - City:EAST RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37412-2265
Mailing Address - Country:US
Mailing Address - Phone:142-388-8236
Mailing Address - Fax:
Practice Address - Street 1:1542 CORA DR
Practice Address - Street 2:
Practice Address - City:EAST RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37412-2265
Practice Address - Country:US
Practice Address - Phone:423-888-2362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN=========OtherTAX ID