Provider Demographics
NPI:1174059158
Name:LOVING SENIOR CARE, LLC
Entity type:Organization
Organization Name:LOVING SENIOR CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-842-7540
Mailing Address - Street 1:1861 WESTEN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-4151
Mailing Address - Country:US
Mailing Address - Phone:270-842-7540
Mailing Address - Fax:270-842-7436
Practice Address - Street 1:1100 TED A CROZIER SR BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-8912
Practice Address - Country:US
Practice Address - Phone:931-648-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care