Provider Demographics
NPI:1427451830
Name:LOVING KINDNESS PCA, LLC
Entity type:Organization
Organization Name:LOVING KINDNESS PCA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PRINCE
Authorized Official - Middle Name:T
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:702-351-8798
Mailing Address - Street 1:720 W CHEYENNE AVE STE 40
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-7817
Mailing Address - Country:US
Mailing Address - Phone:702-351-8798
Mailing Address - Fax:
Practice Address - Street 1:720 W CHEYENNE AVE STE 40
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-7817
Practice Address - Country:US
Practice Address - Phone:702-351-8798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health