Provider Demographics
NPI:1386774883
Name:LOVING HOME HEALTH CARE, INC
Entity type:Organization
Organization Name:LOVING HOME HEALTH CARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTOVETS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-581-3500
Mailing Address - Street 1:14545 VICTORY BLVD STE 604
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-1620
Mailing Address - Country:US
Mailing Address - Phone:818-517-8743
Mailing Address - Fax:818-530-1419
Practice Address - Street 1:14545 VICTORY BLVD STE 604
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-1620
Practice Address - Country:US
Practice Address - Phone:818-849-5842
Practice Address - Fax:818-849-6764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000656251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059039Medicare Oscar/Certification