Provider Demographics
NPI:1215414974
Name:REAL LOVING CARE HOME CARE LLC
Entity Type:Organization
Organization Name:REAL LOVING CARE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANISSA
Authorized Official - Middle Name:GAY
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:330-568-4098
Mailing Address - Street 1:29 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-1773
Mailing Address - Country:US
Mailing Address - Phone:330-534-4284
Mailing Address - Fax:330-534-4495
Practice Address - Street 1:29 JACKSON ST
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425-1773
Practice Address - Country:US
Practice Address - Phone:330-568-4098
Practice Address - Fax:330-534-4495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-25
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========Medicaid