Healthcare Provider Details

I. General information

NPI: 1669380408
Provider Name (Legal Business Name): ELITECARE LOVELY CONGREGATE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1912 MARLOWE ST
THOUSAND OAKS CA
91360-3332
US

IV. Provider business mailing address

1912 MARLOWE ST
THOUSAND OAKS CA
91360-3332
US

V. Phone/Fax

Practice location:
  • Phone: 805-312-9058
  • Fax: 805-312-9059
Mailing address:
  • Phone: 805-312-9058
  • Fax: 805-312-9059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CILVA TOUME
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 805-210-9925