Provider Demographics
| NPI: | 1548881931 |
|---|---|
| Name: | LOVE THY NEIGHBOR CARE, INC |
| Entity type: | Organization |
| Organization Name: | LOVE THY NEIGHBOR CARE, INC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | WANDRETTA |
| Authorized Official - Middle Name: | L |
| Authorized Official - Last Name: | DUDLEY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 352-787-4997 |
| Mailing Address - Street 1: | 2106 BUTLER ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | LEESBURG |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 34748-5502 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 352-787-4997 |
| Mailing Address - Fax: | 352-787-0997 |
| Practice Address - Street 1: | 2106 BUTLER ST |
| Practice Address - Street 2: | |
| Practice Address - City: | LEESBURG |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 34748-5502 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 352-787-4997 |
| Practice Address - Fax: | 352-787-0997 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2020-04-27 |
| Last Update Date: | 2020-04-27 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 253Z00000X | Agencies | In Home Supportive Care | |
| No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | |
| No | 251E00000X | Agencies | Home Health | |
| No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities |
| No | 320600000X | Residential Treatment Facilities | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| No | 310500000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Mental Illness | |
| No | 313M00000X | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility | |
| No | 315P00000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Intellectual Disabilities | |
| No | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | |
| No | 335G00000X | Suppliers | Medical Foods Supplier | |
| No | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | |
| No | 347B00000X | Transportation Services | Bus | |
| No | 347C00000X | Transportation Services | Private Vehicle | |
| No | 385H00000X | Respite Care Facility | Respite Care | |
| No | 385HR2065X | Respite Care Facility | Respite Care | Respite Care, Physical Disabilities, Child |
