Provider Demographics
NPI:1255573473
Name:CAREGIVERS ETC.
Entity type:Organization
Organization Name:CAREGIVERS ETC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LOOYSEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:909-557-7496
Mailing Address - Street 1:33515 PEMBROOK PL
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-3431
Mailing Address - Country:US
Mailing Address - Phone:909-557-7496
Mailing Address - Fax:909-790-6503
Practice Address - Street 1:33515 PEMBROOK PL
Practice Address - Street 2:
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-3431
Practice Address - Country:US
Practice Address - Phone:909-557-7496
Practice Address - Fax:909-790-6503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home