Provider Demographics
NPI:1578078325
Name:CAREALOT HOMES
Entity Type:Organization
Organization Name:CAREALOT HOMES
Other - Org Name:ERIKA'S HOUSE ASSISTED LIVING FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LADAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-933-5953
Mailing Address - Street 1:4965 S 3500 W
Mailing Address - Street 2:
Mailing Address - City:ROY
Mailing Address - State:UT
Mailing Address - Zip Code:84067-9417
Mailing Address - Country:US
Mailing Address - Phone:385-268-8909
Mailing Address - Fax:801-901-6483
Practice Address - Street 1:8301 N GOMEZ AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2814
Practice Address - Country:US
Practice Address - Phone:813-933-5953
Practice Address - Fax:813-442-6551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-01
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1528474723Medicaid