Healthcare Provider Details

I. General information

NPI: 1386461267
Provider Name (Legal Business Name): LOVING FAMILY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13221 PAXTON ST
PACOIMA CA
91331-2337
US

IV. Provider business mailing address

5457 PINE CONE RD
LA CRESCENTA CA
91214-1461
US

V. Phone/Fax

Practice location:
  • Phone: 747-444-1088
  • Fax:
Mailing address:
  • Phone: 347-933-2401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SERGEY ESAYAN
Title or Position: PRESIDENT
Credential:
Phone: 347-933-2401