Provider Demographics
NPI:1871967836
Name:LOVING HOME CARE, LLC
Entity type:Organization
Organization Name:LOVING HOME CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYONG
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-754-9050
Mailing Address - Street 1:4745 PIPER ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1542
Mailing Address - Country:US
Mailing Address - Phone:907-754-9050
Mailing Address - Fax:907-754-9099
Practice Address - Street 1:4745 PIPER ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1542
Practice Address - Country:US
Practice Address - Phone:907-754-9050
Practice Address - Fax:907-754-9099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101119310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK101119OtherASSISTED LIVING HOME LICENSE, DIVISION OF HEALTH CARE SERVICES, STATE OF ALASKA
AKRLXMedicaid