Provider Demographics
NPI:1639635154
Name:LOVE FOCUS INTERNATIONAL ASSOCIATION LFIA
Entity Type:Organization
Organization Name:LOVE FOCUS INTERNATIONAL ASSOCIATION LFIA
Other - Org Name:LOVE FOCUS YOUTH OUTREACH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/INFORMATION TECHNOLOGY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THEOPHILUS
Authorized Official - Middle Name:
Authorized Official - Last Name:NKWOPARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-869-5800
Mailing Address - Street 1:PO BOX 3704
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95344-3704
Mailing Address - Country:US
Mailing Address - Phone:209-869-5800
Mailing Address - Fax:866-310-8868
Practice Address - Street 1:108 W ALEXANDER AVE
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-3410
Practice Address - Country:US
Practice Address - Phone:209-233-9024
Practice Address - Fax:866-310-8868
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOVE FOCUS INTERNATIONAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-20
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty
No164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No251X00000XAgenciesSupports BrokerageGroup - Multi-Specialty
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral DisturbancesGroup - Multi-Specialty
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Multi-Specialty
No374K00000XNursing Service Related ProvidersReligious Nonmedical PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA285790OtherBVN AND PSYCHIATRIC TECHNICIANS
CA247207212OtherFACILITY
CA768074OtherCALIFORNIA BOARD OF REGISTEREDNURSING - BRN
CA65927OtherBBS/LICENSED CLINICAL SOCIAL WORKER
CA851729OtherCALIFORNIA BOARD OF REGISTEREDNURSING - BRN
CA289669OtherBVN AND PSYCHIATRIC TECHNICIANS
CAC3791162OtherSECRETARY OF STATE
CAC4564277OtherSECRETARY OF STATE
CA813953OtherCALIFORNIA BOARD OF REGISTEREDNURSING - BRN
CA279040OtherB VN AND PSYCHIATRIC TECHNICIANS