Provider Demographics
NPI: | 1275099533 |
---|---|
Name: | ILOVE HOME CARE LLC |
Entity Type: | Organization |
Organization Name: | ILOVE HOME CARE LLC |
Other - Org Name: | ILOVE HOME CARE |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | KAFUBA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | DONZON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 260-446-5797 |
Mailing Address - Street 1: | 3706 W FERGUSON RD |
Mailing Address - Street 2: | |
Mailing Address - City: | FORT WAYNE |
Mailing Address - State: | IN |
Mailing Address - Zip Code: | 46809-3157 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 260-446-5797 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3706 W FERGUSON RD |
Practice Address - Street 2: | |
Practice Address - City: | FORT WAYNE |
Practice Address - State: | IN |
Practice Address - Zip Code: | 46809-3157 |
Practice Address - Country: | US |
Practice Address - Phone: | 260-446-5797 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-02-12 |
Last Update Date: | 2019-02-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 253Z00000X | Agencies | In Home Supportive Care | Group - Multi-Specialty | |
No | 376J00000X | Nursing Service Related Providers | Homemaker | Group - Multi-Specialty |