Provider Demographics
NPI:1629241989
Name:LOVE & CARE BOARDING CARE
Entity Type:Organization
Organization Name:LOVE & CARE BOARDING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADULT RESIDENTIAL CARE
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRILLANTES
Authorized Official - Suffix:
Authorized Official - Credentials:ALF
Authorized Official - Phone:562-529-8127
Mailing Address - Street 1:11866 162ND ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-7226
Mailing Address - Country:US
Mailing Address - Phone:562-529-8127
Mailing Address - Fax:
Practice Address - Street 1:11866 162ND ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-7226
Practice Address - Country:US
Practice Address - Phone:562-529-8127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility