Provider Demographics
NPI:1144841826
Name:LOVE AND CARE ADULT DAYCARE AND PERSONAL CARE SERVICES
Entity type:Organization
Organization Name:LOVE AND CARE ADULT DAYCARE AND PERSONAL CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:662-453-2064
Mailing Address - Street 1:521 BRENTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38930-6910
Mailing Address - Country:US
Mailing Address - Phone:662-453-2064
Mailing Address - Fax:662-453-2064
Practice Address - Street 1:521 BRENTWOOD AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930-6910
Practice Address - Country:US
Practice Address - Phone:662-453-2064
Practice Address - Fax:662-453-2064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service