Provider Demographics
NPI:1750165148
Name:LAI CARE LOVE LLC
Entity type:Organization
Organization Name:LAI CARE LOVE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUCAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:682-328-7246
Mailing Address - Street 1:9769 WALNUT COVE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76108-2235
Mailing Address - Country:US
Mailing Address - Phone:682-328-7246
Mailing Address - Fax:
Practice Address - Street 1:9769 WALNUT COVE DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76108-2235
Practice Address - Country:US
Practice Address - Phone:682-328-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care