Basic Information
| Provider Information | |||||||||
| NPI: | 1356498521 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LOVING CARE AND MORE, INC. | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 119 | ||||||||
| Address2: | |||||||||
| City: | SILVERTON | ||||||||
| State: | ID | ||||||||
| PostalCode: | 838670119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2087521019 | ||||||||
| FaxNumber: | 2087521063 | ||||||||
| Practice Location | |||||||||
| Address1: | 104 WINDRIVER RD | ||||||||
| Address2: | |||||||||
| City: | SILVERTON | ||||||||
| State: | ID | ||||||||
| PostalCode: | 838670119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2087521019 | ||||||||
| FaxNumber: | 2087521063 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2007 | ||||||||
| LastUpdateDate: | 10/01/2010 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | HULL | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2087521019 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | RN | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | HH-149 | ID | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 807284200 | 05 | ID | MEDICAID | 002916900 | 05 | ID | MEDICAID | 002916800 | 05 | ID | MEDICAID | 807186200 | 05 | ID | MEDICAID | 807284100 | 05 | ID | MEDICAID |