MEDICARE: LOVING ARMS HAVEN LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1568319887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVING ARMS HAVEN LLC

Provider Business Mailing Address
First Line	:	6402 MISSION RIDGE DR
Second Line	:
City	:	PASCO
State	:	WA
Zip	:	99301-8040
Country	:	US
Telephone Number	:	509-851-9734
Fax Number	:	509-851-9734

Provider Business Practice Location Address
First Line	:	6402 MISSION RIDGE DR
Second Line	:
City	:	PASCO
State	:	WA
Zip	:	99301-8040
Country	:	US
Telephone Number	:	509-851-9734
Fax Number	:	509-851-9734

Authorized Official
Title or Position	:	OWNER
Name	:	ALCIRA YARELY GUILLEN
Credential	:	RN
Telephone Number	:	509-851-9734

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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