Provider Demographics
NPI:1548994064
Name:LOVING CARE DISABILITY SERVICES, LLC
Entity type:Organization
Organization Name:LOVING CARE DISABILITY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SOUROU
Authorized Official - Middle Name:VALERY WILSON
Authorized Official - Last Name:PLAGBETO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-375-5728
Mailing Address - Street 1:1 HERMOSA PL APT 104
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-7705
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 HERMOSA PL APT 104
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-7705
Practice Address - Country:US
Practice Address - Phone:347-375-5728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities