Healthcare Provider Details

I. General information

NPI: 1689531030
Provider Name (Legal Business Name): LOVING ANGELS CAREHOME 2
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4722 HACKBERRY LN
CARMICHAEL CA
95608-2239
US

IV. Provider business mailing address

4722 HACKBERRY LN
CARMICHAEL CA
95608-2239
US

V. Phone/Fax

Practice location:
  • Phone: 916-999-0931
  • Fax: 916-993-6973
Mailing address:
  • Phone: 916-999-0931
  • Fax: 916-993-6973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MIRASOL MUNGCAL
Title or Position: ADMISTRATOR
Credential:
Phone: 916-346-7312