Provider Demographics
NPI:1992299390
Name:LOVE CARE CENTER LLC
Entity type:Organization
Organization Name:LOVE CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NIDAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-650-1675
Mailing Address - Street 1:1333 POINDEXTER ST STE 1-A
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23324-2428
Mailing Address - Country:US
Mailing Address - Phone:757-963-9522
Mailing Address - Fax:757-963-9515
Practice Address - Street 1:1333 POINDEXTER ST STE 1-A
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23324-2428
Practice Address - Country:US
Practice Address - Phone:757-963-9522
Practice Address - Fax:757-963-9515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1812805251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health