Healthcare Provider Details

I. General information

NPI: 1144731449
Provider Name (Legal Business Name): LIFETOUCH CARE, IC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2017
Last Update Date: 10/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 WINTHROP AVE
ARCADIA CA
91007-8436
US

IV. Provider business mailing address

2701 WINTHROP AVE
ARCADIA CA
91007-8436
US

V. Phone/Fax

Practice location:
  • Phone: 626-461-5638
  • Fax:
Mailing address:
  • Phone: 626-461-5638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MS. JUSTINE MARIE ALICAYA BRAGA
Title or Position: REGISTERED NURSE
Credential:
Phone: 626-461-5638