Healthcare Provider Details

I. General information

NPI: 1912321035
Provider Name (Legal Business Name): NEIGHBORHOOD LIFE CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2014
Last Update Date: 09/02/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 FOOTHILL BLVD
LA VERNE CA
91750-3560
US

IV. Provider business mailing address

2025 FOOTHILL BLVD
LA VERNE CA
91750-3560
US

V. Phone/Fax

Practice location:
  • Phone: 909-435-4663
  • Fax: 888-456-9375
Mailing address:
  • Phone: 909-525-7883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: RANDY ALLISON
Title or Position: OWNER
Credential:
Phone: 909-435-4663