Provider Demographics
NPI:1487137030
Name:K AND L LOVING CARE OF LEHIGH ACRES ASSISTED LIVING FACILITY INC.
Entity type:Organization
Organization Name:K AND L LOVING CARE OF LEHIGH ACRES ASSISTED LIVING FACILITY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LOTOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HIBBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-628-8075
Mailing Address - Street 1:3825 ASPEN LEAF DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-1713
Mailing Address - Country:US
Mailing Address - Phone:561-628-8075
Mailing Address - Fax:
Practice Address - Street 1:4504 6TH ST W
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-1100
Practice Address - Country:US
Practice Address - Phone:561-628-8075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child