Provider Demographics
NPI:1063304897
Name:IMACTFUL LOVE AND CAARE LLC
Entity type:Organization
Organization Name:IMACTFUL LOVE AND CAARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GNA/CNA/CMT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:KALA
Authorized Official - Last Name:DUBOSE
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:202-300-1128
Mailing Address - Street 1:615 CRANBROOK RD APT E
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-3845
Mailing Address - Country:US
Mailing Address - Phone:202-300-1128
Mailing Address - Fax:
Practice Address - Street 1:615 CRANBROOK RD APT E
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-3845
Practice Address - Country:US
Practice Address - Phone:202-300-1128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty