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General NPI Number Information
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NPI Number | 1255786448
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Entity Type | Organization
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Legal Business Name | K'S LOVING CARE
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Dates
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Enumeration Date | 04/26/2016
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Last Update Date | 04/26/2016
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Provider Practice Location Address
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Address Line | 1211 N AMELIA ST
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City | ANAHEIM
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State | CA
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Zip | 92807
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Country | US
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Telephone | 714-803-4399
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Fax |
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Provider Business Mailing Address
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Address Line | 1211 N AMELIA ST
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City | ANAHEIM
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State | CA
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Zip | 92807
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Country | US
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Telephone | 714-803-4399
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. EYOB KEBEDE
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Credential |
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Telephone | 714-803-4399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 306001456
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License Number State | CA
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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 | 306004126
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License Number State | CA
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