Provider Demographics
NPI:1851186159
Name:LIDO-LOVE HOME CARE AGENCY LLC
Entity type:Organization
Organization Name:LIDO-LOVE HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AHOLOTU
Authorized Official - Middle Name:A FAFINE
Authorized Official - Last Name:MALIUKAETAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-586-9514
Mailing Address - Street 1:16018 42ND AVE S
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-3011
Mailing Address - Country:US
Mailing Address - Phone:510-586-9514
Mailing Address - Fax:
Practice Address - Street 1:16018 42ND AVE S
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-3011
Practice Address - Country:US
Practice Address - Phone:510-586-9514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care