Provider Demographics
NPI:1649792763
Name:LUVLEE'S RESIDENTIAL CARE, INC.
Entity type:Organization
Organization Name:LUVLEE'S RESIDENTIAL CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-594-2762
Mailing Address - Street 1:PO BOX 2232
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91788-2232
Mailing Address - Country:US
Mailing Address - Phone:909-594-2762
Mailing Address - Fax:909-594-2922
Practice Address - Street 1:4340 WILSON ST
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-3233
Practice Address - Country:US
Practice Address - Phone:909-590-0805
Practice Address - Fax:909-594-2922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-11
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA360908565322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children