Provider Demographics
NPI:1427856970
Name:LOVING HAVEN GROUP HOME LLC
Entity type:Organization
Organization Name:LOVING HAVEN GROUP HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KITANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHUE-HOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-379-2431
Mailing Address - Street 1:5900 N 68TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-1801
Mailing Address - Country:US
Mailing Address - Phone:414-433-9397
Mailing Address - Fax:414-433-9387
Practice Address - Street 1:5900 N 68TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-1801
Practice Address - Country:US
Practice Address - Phone:414-433-9397
Practice Address - Fax:414-433-9387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home