Provider Demographics
NPI:1205296399
Name:BELOVED HOME CARE
Entity type:Organization
Organization Name:BELOVED HOME CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:CHIMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-934-3475
Mailing Address - Street 1:255 S GLENDORA AVE UNIT 1542
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-7179
Mailing Address - Country:US
Mailing Address - Phone:818-934-3475
Mailing Address - Fax:
Practice Address - Street 1:255 S GLENDORA AVE UNIT 1542
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-7179
Practice Address - Country:US
Practice Address - Phone:818-934-3475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care