Provider Demographics
NPI:1316665177
Name:GENUINE LOVE IN HOME CARE,LLC
Entity type:Organization
Organization Name:GENUINE LOVE IN HOME CARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRECIOUS
Authorized Official - Middle Name:
Authorized Official - Last Name:CRADDIETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:668-889-8006
Mailing Address - Street 1:4780 I 55 N STE 100
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-5583
Mailing Address - Country:US
Mailing Address - Phone:166-288-9800
Mailing Address - Fax:
Practice Address - Street 1:818 CROWE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39702-9431
Practice Address - Country:US
Practice Address - Phone:662-889-8006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care