1508112160 NPI number — LOVING CARE REFERRALS, LTD.

Table of content: MISS ALEXANDRIA WALLACE HAD (NPI 1043816325)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508112160 NPI number — LOVING CARE REFERRALS, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOVING CARE REFERRALS, LTD.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508112160
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2008 SANTIAGO ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89104-2918
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2008 SANTIAGO ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89104-2918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-450-1704
Provider Business Practice Location Address Fax Number:
702-450-1704
Provider Enumeration Date:
07/31/2012

Additional Information

Authorized Official

Authorized Official Last Name:
NOTARO
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
JOHN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
702-450-1704

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  7305PCS-0 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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