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General NPI Number Information
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NPI Number | 1114464807
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Entity Type | Organization
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Legal Business Name | LOLI IN-HOME CARE LLC
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Dates
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Enumeration Date | 01/19/2017
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Last Update Date | 01/19/2017
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Provider Practice Location Address
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Address Line | 2409 N SEPULVEDA BLVD SUITE # 301
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City | MANHATTAN BEACH
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State | CA
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Zip | 90266-2947
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Country | US
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Telephone | 310-546-3400
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Fax | 310-546-3409
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Provider Business Mailing Address
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Address Line | 2409 N SEPULVEDA BLVD SUITE # 301
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City | MANHATTAN BEACH
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State | CA
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Zip | 90266-2947
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Country | US
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Telephone | 310-546-3400
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Fax | 310-546-3409
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Authorized Official
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Title or Position | OWNER
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Name | LOLI RAMEZANI
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Credential |
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Telephone | 310-546-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 194700013
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 194700013
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License Number State | CA
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