Provider Demographics
NPI:1851166854
Name:A LOYAL HAND HOME CARE II
Entity type:Organization
Organization Name:A LOYAL HAND HOME CARE II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAREISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSTIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-285-5587
Mailing Address - Street 1:120 READ TAVERN RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-6739
Mailing Address - Country:US
Mailing Address - Phone:314-285-5587
Mailing Address - Fax:
Practice Address - Street 1:120 READ TAVERN RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-6739
Practice Address - Country:US
Practice Address - Phone:314-285-5587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health