Provider Demographics
NPI:1013767839
Name:HEALTH LOFT SERVICES LLC
Entity Type:Organization
Organization Name:HEALTH LOFT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CAGINALP
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:516-998-5053
Mailing Address - Street 1:1640 W DIVISION ST APT 508
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-3939
Mailing Address - Country:US
Mailing Address - Phone:516-998-5053
Mailing Address - Fax:855-631-0531
Practice Address - Street 1:7522 N LOMBARD ST STE A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-3235
Practice Address - Country:US
Practice Address - Phone:855-552-5557
Practice Address - Fax:855-631-0531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty