Provider Demographics
NPI:1831556000
Name:LOYAL CARE HOME SERVICES
Entity type:Organization
Organization Name:LOYAL CARE HOME SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:D
Authorized Official - Last Name:LARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-580-3352
Mailing Address - Street 1:2311 MARLTON PIKE W
Mailing Address - Street 2:SUITE 13
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-3390
Mailing Address - Country:US
Mailing Address - Phone:856-580-3352
Mailing Address - Fax:
Practice Address - Street 1:2311 MARLTON PIKE W
Practice Address - Street 2:SUITE 13
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-3390
Practice Address - Country:US
Practice Address - Phone:856-580-3352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0215500251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health