Provider Demographics
NPI:1336560937
Name:CR LOVING CARE, INC.
Entity Type:Organization
Organization Name:CR LOVING CARE, INC.
Other - Org Name:C R LOVING CARE 2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR / OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-503-9671
Mailing Address - Street 1:74 PRINCE MICHAEL LN
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-7154
Mailing Address - Country:US
Mailing Address - Phone:386-446-1072
Mailing Address - Fax:
Practice Address - Street 1:74 PRINCE MICHAEL LN
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-7154
Practice Address - Country:US
Practice Address - Phone:386-446-1072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-27
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12093310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility