Healthcare Provider Details
I. General information
NPI: 1730576513
Provider Name (Legal Business Name): LOYALTY CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/20/2015
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7171 SW 24TH ST STE 417A
MIAMI FL
33155-1693
US
IV. Provider business mailing address
7171 SW 24TH ST STE 417A
MIAMI FL
33155-1693
US
V. Phone/Fax
- Phone: 786-615-6620
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 320900000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NELSON
M
MARTINEZ
Title or Position: OWNER
Credential:
Phone: 786-615-6620