Provider Demographics
NPI:1437430675
Name:LP.A. & T. CORPORATION
Entity Type:Organization
Organization Name:LP.A. & T. CORPORATION
Other - Org Name:ROSELAND I,II,III,IV,V SONIA'S ARF
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIBERTY
Authorized Official - Middle Name:CRUZ
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN-BSN/DON/ADMINISTR
Authorized Official - Phone:619-216-6357
Mailing Address - Street 1:1262 DIXON WAY
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911
Mailing Address - Country:US
Mailing Address - Phone:619-426-6357
Mailing Address - Fax:619-422-1805
Practice Address - Street 1:1262 DIXON WAY
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911
Practice Address - Country:US
Practice Address - Phone:619-426-6357
Practice Address - Fax:619-422-1805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN301810163W00000X
CAVN168658164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SIERRA214039551OtherHEALTH CARE PROVIDER