Provider Demographics
NPI:1699553461
Name:SARA LOVING CARE
Entity type:Organization
Organization Name:SARA LOVING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:DANIAL
Authorized Official - Last Name:ABUJABER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-935-9569
Mailing Address - Street 1:9407 CANABRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:TN
Mailing Address - Zip Code:38002-4179
Mailing Address - Country:US
Mailing Address - Phone:731-935-9569
Mailing Address - Fax:
Practice Address - Street 1:1053 PERRY SWITCH RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-9561
Practice Address - Country:US
Practice Address - Phone:731-935-9569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-21
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities