Provider Demographics
NPI:1285062414
Name:A LOVING CARE PCA
Entity type:Organization
Organization Name:A LOVING CARE PCA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAVAEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-602-5811
Mailing Address - Street 1:343 W BENSON BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3950
Mailing Address - Country:US
Mailing Address - Phone:907-222-3237
Mailing Address - Fax:
Practice Address - Street 1:343 W BENSON BLVD STE 4
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3950
Practice Address - Country:US
Practice Address - Phone:907-222-3237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A LOVING CARE PCA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-25
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1584754Medicaid