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Organization
LOYAL SERVICE AGENCY INC.
Active
Organization
LOYAL SERVICE AGENCY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LONNEL M SANDOVAL-ASEBEDO R.N. (OWNER)
(505) 285-2966
Entity
Organization
Contact information
Practice address
103 GOLTZ DR, GRANTS, NM 87020-2155
(505) 285-2966
(505) 285-4055
Mailing address
103 GOLTZ DR, GRANTS, NM 87020-2155
(505) 285-2966
(505) 285-4055
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
3351
NM
Other
Enumeration date
08/29/2014
Last updated
08/29/2014
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