Healthcare Provider Details

I. General information

NPI: 1184410383
Provider Name (Legal Business Name): LOVING CARE SOCIAL CLUB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19717 NW 37TH AVE
MIAMI GARDENS FL
33056-2250
US

IV. Provider business mailing address

19717 NW 37TH AVE
MIAMI GARDENS FL
33056-2250
US

V. Phone/Fax

Practice location:
  • Phone: 305-859-1024
  • Fax: 305-974-5326
Mailing address:
  • Phone: 305-859-1024
  • Fax: 305-974-5326

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: ELSALENA VALENTIN
Title or Position: PRESIDENT
Credential:
Phone: 786-301-5615