1558427609 NPI number — THE LOVING HOME, INC.

Table of content: JODY ELIZABETH NAVITSKY MD (NPI 1609812080)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558427609 NPI number — THE LOVING HOME, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE LOVING HOME, INC.
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:
Provider Other Organization Name Type Code:
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:
1558427609
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4944 MACEDONIA CHURCH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAYETTEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28312-5896
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-485-4742
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4944 MACEDONIA CHURCH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28312-5896
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-485-4742
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
OKORIEOCHA
Authorized Official First Name:
DESMOND
Authorized Official Middle Name:
ONYE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
910-485-4742

Provider Taxonomy Codes

  • Taxonomy code: 320600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3408341 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8301278B . This is a "COMMUNITY SUPPORT SERVICE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7804953 . This is a "ADULT CARE HOME FPR PCS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com