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General NPI Number Information
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NPI Number | 1487137030
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Entity Type | Organization
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Legal Business Name | K AND L LOVING CARE OF LEHIGH ACRES ASSISTED LIVING FACILITY INC.
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Dates
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Enumeration Date | 09/10/2018
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Last Update Date | 09/10/2018
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Provider Practice Location Address
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Address Line | 4504 6TH ST W
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City | LEHIGH ACRES
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State | FL
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Zip | 33971-1100
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Country | US
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Telephone | 561-628-8075
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Fax |
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Provider Business Mailing Address
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Address Line | 3825 ASPEN LEAF DR
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-1713
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Country | US
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Telephone | 561-628-8075
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LOTOYA HIBBERT
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Credential |
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Telephone | 561-628-8075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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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 | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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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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