Provider Demographics
NPI:1669171617
Name:LOVING CARE RESIDENTIAL SERVICES LLC
Entity type:Organization
Organization Name:LOVING CARE RESIDENTIAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAQUITA
Authorized Official - Middle Name:SHONTE
Authorized Official - Last Name:MCCRAE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-689-0845
Mailing Address - Street 1:418 OLD KESWICK LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH PRINCE GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:23805-7867
Mailing Address - Country:US
Mailing Address - Phone:804-689-0845
Mailing Address - Fax:
Practice Address - Street 1:418 OLD KESWICK LN
Practice Address - Street 2:
Practice Address - City:SOUTH PRINCE GEORGE
Practice Address - State:VA
Practice Address - Zip Code:23805-7867
Practice Address - Country:US
Practice Address - Phone:804-689-0845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities