Organization
LOVING CARE AGENCY, INC.
Active
Other names
AVEANNA HEALTHCARE
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI WHITESIDE (DIRECTOR, REGULATORY LICENSING)
(770) 248-8740
Entity
Organization
Contact information
Practice address
2600 ROOSEVELT RD STE 200-1, VALPARAISO, IN 46383-0971
(219) 548-0099
(219) 548-0024
Mailing address
5220 SPRING VALLEY RD, SUITE 400, DALLAS, TX 75254-3099
(214) 466-1351
(214) 466-1378
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
09-012050-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200884790
MEDICAID WAIVER
IN
Enumeration date
02/03/2010
Last updated
02/08/2019
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