Provider Demographics
NPI:1902286354
Name:AFFECTIONATE HOSPICE CARE, LLC
Entity Type:Organization
Organization Name:AFFECTIONATE HOSPICE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LORILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAON
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:702-629-7308
Mailing Address - Street 1:1641 E. FLAMINGO RD.
Mailing Address - Street 2:SUITE 8
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-9998
Mailing Address - Country:US
Mailing Address - Phone:702-629-7308
Mailing Address - Fax:702-834-3797
Practice Address - Street 1:1641 E FLAMINGO RD
Practice Address - Street 2:SUITE 8
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5257
Practice Address - Country:US
Practice Address - Phone:702-629-7308
Practice Address - Fax:702-834-3797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-01
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based