Provider Demographics
NPI:1447465521
Name:THE LOVING KIND CARE HOME LLC
Entity type:Organization
Organization Name:THE LOVING KIND CARE HOME LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:REESOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-550-0864
Mailing Address - Street 1:14602 N 47TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-4835
Mailing Address - Country:US
Mailing Address - Phone:602-550-0864
Mailing Address - Fax:
Practice Address - Street 1:14602 N 47TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4835
Practice Address - Country:US
Practice Address - Phone:602-550-0864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZALH1921310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility