Provider Demographics
NPI:1841016144
Name:LOVE COMMUNITY HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:LOVE COMMUNITY HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:LAMONT
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:618-550-6090
Mailing Address - Street 1:112 MEADOWCREST DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62221-6749
Mailing Address - Country:US
Mailing Address - Phone:618-550-6090
Mailing Address - Fax:518-880-5027
Practice Address - Street 1:112 MEADOWCREST DR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62221-6749
Practice Address - Country:US
Practice Address - Phone:618-550-6090
Practice Address - Fax:518-880-5027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-02
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities