Provider Demographics
NPI:1992433155
Name:ASSIST TO LIVE HOME CARE CAREGIVER SERVICES
Entity type:Organization
Organization Name:ASSIST TO LIVE HOME CARE CAREGIVER SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CASE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:THADISON
Authorized Official - Suffix:
Authorized Official - Credentials:CNA, LVN, LPN
Authorized Official - Phone:407-748-6006
Mailing Address - Street 1:3719 ACACIA WOOD WAY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449
Mailing Address - Country:US
Mailing Address - Phone:409-748-6006
Mailing Address - Fax:
Practice Address - Street 1:3719 ACACIA WOOD WAY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449
Practice Address - Country:US
Practice Address - Phone:409-748-6006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASSISTTO LIVE HOME CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty