Provider Demographics
NPI:1992457782
Name:HOME OF LOVE HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:HOME OF LOVE HEALTHCARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SULAIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:SANUSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-606-3698
Mailing Address - Street 1:426 WRENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-3398
Mailing Address - Country:US
Mailing Address - Phone:704-606-3698
Mailing Address - Fax:
Practice Address - Street 1:426 WRENWOOD DR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27527-3398
Practice Address - Country:US
Practice Address - Phone:980-229-3351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-22
Last Update Date:2022-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child