Healthcare Provider Details

I. General information

NPI: 1497600282
Provider Name (Legal Business Name): BELOVED HOUSING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21070 RANCHERIAS RD
APPLE VALLEY CA
92307-5812
US

IV. Provider business mailing address

21070 RANCHERIAS RD
APPLE VALLEY CA
92307-5812
US

V. Phone/Fax

Practice location:
  • Phone: 760-285-4188
  • Fax:
Mailing address:
  • Phone: 760-285-4188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: COLLEEN MCCOY
Title or Position: CEO
Credential:
Phone: 760-285-4188