Provider Demographics
NPI:1770396129
Name:LOVE IN ACTION HOMECARE
Entity type:Organization
Organization Name:LOVE IN ACTION HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YERUKNESH
Authorized Official - Middle Name:ADMASSU
Authorized Official - Last Name:ENDALAMAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-405-8992
Mailing Address - Street 1:4710 GREENCASTLE RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-3142
Mailing Address - Country:US
Mailing Address - Phone:571-405-8992
Mailing Address - Fax:
Practice Address - Street 1:4710 GREENCASTLE RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-3142
Practice Address - Country:US
Practice Address - Phone:571-405-8992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care