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General NPI Number Information
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NPI Number | 1114896099
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Entity Type | Organization
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Legal Business Name | GENUINE LOVING CARE ADULT FAMILY HOME LLC
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Dates
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Enumeration Date | 10/30/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 827 3 MILE RD
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City | RACINE
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State | WI
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Zip | 53402-2901
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Country | US
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Telephone | 863-308-1318
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Fax |
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Provider Business Mailing Address
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Address Line | 7221 W WABASH AVE
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City | MILWAUKEE
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State | WI
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Zip | 53223-2608
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Country | US
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Telephone | 262-402-8615
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TYRA HOARD
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Credential | LPN
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Telephone | 863-308-1318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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