Provider Demographics
NPI:1801128772
Name:LOVING CARE AGENCY, INC.
Entity type:Organization
Organization Name:LOVING CARE AGENCY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, REGULATORY LICENSING
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITESIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-248-8740
Mailing Address - Street 1:5220 SPRING VALLEY RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-3099
Mailing Address - Country:US
Mailing Address - Phone:214-466-1351
Mailing Address - Fax:214-466-1378
Practice Address - Street 1:2600 ROOSEVELT RD STE 200-1
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-0971
Practice Address - Country:US
Practice Address - Phone:219-548-0099
Practice Address - Fax:219-548-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN09-012050-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200884790OtherMEDICAID WAIVER