Provider Demographics
NPI:1164952545
Name:ADELANTO LOVING CARE INC.
Entity Type:Organization
Organization Name:ADELANTO LOVING CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:TSIMOGIANIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-565-9304
Mailing Address - Street 1:15093 ARCADIAN ST
Mailing Address - Street 2:
Mailing Address - City:ADELANTO
Mailing Address - State:CA
Mailing Address - Zip Code:92301-6111
Mailing Address - Country:US
Mailing Address - Phone:760-565-9304
Mailing Address - Fax:760-523-1447
Practice Address - Street 1:15093 ARCADIAN ST
Practice Address - Street 2:
Practice Address - City:ADELANTO
Practice Address - State:CA
Practice Address - Zip Code:92301-6111
Practice Address - Country:US
Practice Address - Phone:760-565-9304
Practice Address - Fax:760-523-1447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA366426090311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home