Provider Demographics
NPI:1609407238
Name:LORIA, CHRISTINE FLORENCE
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:FLORENCE
Last Name:LORIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8097 WILDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MANCELONA
Mailing Address - State:MI
Mailing Address - Zip Code:49659-8883
Mailing Address - Country:US
Mailing Address - Phone:231-409-6602
Mailing Address - Fax:
Practice Address - Street 1:8097 WILDWOOD DR
Practice Address - Street 2:
Practice Address - City:MANCELONA
Practice Address - State:MI
Practice Address - Zip Code:49659-8883
Practice Address - Country:US
Practice Address - Phone:231-409-6602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-02
Last Update Date:2020-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility