Healthcare Provider Details

I. General information

NPI: 1841771425
Provider Name (Legal Business Name): LFQ SENIOR CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2018
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22772 CENTRE DR STE 200
LAKE FOREST CA
92630-6303
US

IV. Provider business mailing address

22772 CENTRE DR STE 200
LAKE FOREST CA
92630-6303
US

V. Phone/Fax

Practice location:
  • Phone: 949-583-7888
  • Fax: 949-583-1090
Mailing address:
  • Phone: 949-583-7888
  • Fax: 949-583-1090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number304700103
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number304700103
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number304700103
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number304700103
License Number StateCA

VIII. Authorized Official

Name: MR. SERAFIN AGUIRRE
Title or Position: ADMINISTRATOR
Credential:
Phone: 949-583-7888