Provider Demographics
NPI:1780462358
Name:LOYAL OAK HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:LOYAL OAK HOME HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SANESIA
Authorized Official - Middle Name:SAMANTHA
Authorized Official - Last Name:MCKANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-487-7148
Mailing Address - Street 1:3291 NW 114TH AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-3107
Mailing Address - Country:US
Mailing Address - Phone:954-487-7148
Mailing Address - Fax:
Practice Address - Street 1:633 NE 167TH ST # 821
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-2442
Practice Address - Country:US
Practice Address - Phone:954-487-7148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-15
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty