Healthcare Provider Details

I. General information

NPI: 1629660675
Provider Name (Legal Business Name): LOYAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2021
Last Update Date: 09/02/2025
Certification Date: 08/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8442 S US HIGHWAY 1
PORT SAINT LUCIE FL
34952-3306
US

IV. Provider business mailing address

8442 S US HIGHWAY 1
PORT SAINT LUCIE FL
34952-3306
US

V. Phone/Fax

Practice location:
  • Phone: 772-777-8516
  • Fax: 772-777-8519
Mailing address:
  • Phone: 772-777-8516
  • Fax: 772-777-8519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: JASMINE NOEL
Title or Position: ADMINISTRATOR
Credential:
Phone: 772-777-8516