Provider Demographics
NPI:1073858452
Name:LOVING HOME CARE
Entity Type:Organization
Organization Name:LOVING HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:GOLDASSIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-582-8839
Mailing Address - Street 1:22270 PERALTA ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-3920
Mailing Address - Country:US
Mailing Address - Phone:510-582-8839
Mailing Address - Fax:
Practice Address - Street 1:22270 PERALTA ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-3920
Practice Address - Country:US
Practice Address - Phone:510-582-8839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA015601469315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient