Provider Demographics
NPI:1336644160
Name:LAVOIA ADULT FAMILY CARE HOME LLC
Entity Type:Organization
Organization Name:LAVOIA ADULT FAMILY CARE HOME LLC
Other - Org Name:LAVOIA YNETTE TAYLOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:LAVOIA
Authorized Official - Middle Name:YNETTE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-755-2841
Mailing Address - Street 1:114 SMOKEY HILL AVE
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-6326
Mailing Address - Country:US
Mailing Address - Phone:941-465-5505
Mailing Address - Fax:813-773-7713
Practice Address - Street 1:114 SMOKEY HILL AVE
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33570-6326
Practice Address - Country:US
Practice Address - Phone:941-465-5505
Practice Address - Fax:813-773-7713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-25
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care HomeGroup - Single Specialty