Provider Demographics
NPI:1053764316
Name:LOVE THY NEIGHBOR HOME HEALTH CARE INC
Entity type:Organization
Organization Name:LOVE THY NEIGHBOR HOME HEALTH 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:352-409-0919
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:352-409-0919
Mailing Address - Fax:
Practice Address - Street 1:2620 INDUSTRIAL ST
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-3611
Practice Address - Country:US
Practice Address - Phone:352-787-0499
Practice Address - Fax:352-561-2064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-21
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL121578900Medicaid
FL108379100Medicaid