Provider Demographics
NPI:1821553553
Name:LOYALTY HOSPICE SERVICES, INC.
Entity Type:Organization
Organization Name:LOYALTY HOSPICE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PROCOPIO
Authorized Official - Middle Name:T
Authorized Official - Last Name:MISA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:657-208-1813
Mailing Address - Street 1:1700 E LINCOLN AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-4347
Mailing Address - Country:US
Mailing Address - Phone:657-208-1813
Mailing Address - Fax:714-333-4638
Practice Address - Street 1:1700 E LINCOLN AVE STE 204
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-4347
Practice Address - Country:US
Practice Address - Phone:657-208-1813
Practice Address - Fax:714-333-4638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC4238324OtherSECRETARY OF STATE