Provider Demographics
NPI:1013136183
Name:LOVING CARE ADULT DAY CARE AND HEALTH CENTER INC.
Entity Type:Organization
Organization Name:LOVING CARE ADULT DAY CARE AND HEALTH CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JENOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-391-2776
Mailing Address - Street 1:7917 MOORES CHAPEL RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-1559
Mailing Address - Country:US
Mailing Address - Phone:704-391-2776
Mailing Address - Fax:704-391-3720
Practice Address - Street 1:7917 MOORES CHAPEL RD
Practice Address - Street 2:SUITE D
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28214-1559
Practice Address - Country:US
Practice Address - Phone:704-391-2776
Practice Address - Fax:704-391-3720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409035Medicaid