1235792250 NPI number — YOU ARE LOVED HOME HEALTH CARE LLC

Table of content: (NPI 1235792250)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235792250 NPI number — YOU ARE LOVED HOME HEALTH CARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YOU ARE LOVED HOME HEALTH CARE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
YOU ARE LOVED HOME HEALTH CARE LLC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235792250
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10042 EMERALD FOREST DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HERNANDO
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
38632-6404
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
662-368-2575
Provider Business Mailing Address Fax Number:
662-590-0934

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10042 EMERALD FOREST DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HERNANDO
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38632-6404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-368-2575
Provider Business Practice Location Address Fax Number:
662-590-0934
Provider Enumeration Date:
04/16/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BRUNSON
Authorized Official First Name:
MRS.MONIQUE
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING DIRECTOR
Authorized Official Telephone Number:
901-290-2048

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 347C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 374U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 385H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 385HR2065X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)