Provider Demographics
NPI:1235529470
Name:LOVE AND SERENITY HOME CARE
Entity Type:Organization
Organization Name:LOVE AND SERENITY HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:916-627-8790
Mailing Address - Street 1:5942 PARK VILLAGE ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-3463
Mailing Address - Country:US
Mailing Address - Phone:916-476-5595
Mailing Address - Fax:916-367-5336
Practice Address - Street 1:5942 PARK VILLAGE ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-3463
Practice Address - Country:US
Practice Address - Phone:916-476-5595
Practice Address - Fax:916-367-5336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347005095310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility