Provider Demographics
NPI:1194427021
Name:ARCHERS LOVELY HEARTS HOME CARE &NRSA
Entity type:Organization
Organization Name:ARCHERS LOVELY HEARTS HOME CARE &NRSA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BORNITT
Authorized Official - Middle Name:TACAVAKIDES
Authorized Official - Last Name:ARCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-722-9781
Mailing Address - Street 1:2031 E BELVEDERE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-3231
Mailing Address - Country:US
Mailing Address - Phone:443-722-9781
Mailing Address - Fax:
Practice Address - Street 1:2031 E BELVEDERE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-3231
Practice Address - Country:US
Practice Address - Phone:443-722-9781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-22
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical LaboratoryGroup - Single Specialty