Provider Demographics
NPI:1942933270
Name:LOVING HOME CARE 1 LLC
Entity Type:Organization
Organization Name:LOVING HOME CARE 1 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GRIFFIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KANOBANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-267-9052
Mailing Address - Street 1:4550 N 92ND LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-2451
Mailing Address - Country:US
Mailing Address - Phone:781-267-9052
Mailing Address - Fax:
Practice Address - Street 1:4550 N 92ND LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-2451
Practice Address - Country:US
Practice Address - Phone:781-267-9052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health