Provider Demographics
NPI:1053552364
Name:LOVING HAND RESPITE CARE
Entity type:Organization
Organization Name:LOVING HAND RESPITE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MS
Authorized Official - First Name:THEA
Authorized Official - Middle Name:ADAMS
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:662-378-3423
Mailing Address - Street 1:935 MCALLISTER STREET
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38701
Mailing Address - Country:US
Mailing Address - Phone:662-378-3423
Mailing Address - Fax:
Practice Address - Street 1:935 MCALLISTER ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38701-5808
Practice Address - Country:US
Practice Address - Phone:662-378-3423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSP279862385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00770231Medicaid