# LOVING LEGENDS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821827742
- **Authorized official:** DR. SHAVONDA GREENE DHA (ADMINISTRATOR)
- **Authorized official phone:** (951) 545-7203

## Contact information

- **Practice address:** 408 E MISSION PL, CORONA, CA 92879-2829
- **Practice address phone:** (951) 545-7203
- **Practice address fax:** (626) 227-0626
- **Mailing address:** 750 S LINCOLN AVE STE 464, CORONA, CA 92882-3551
- **Mailing address phone:** (951) 545-7203

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 177F00000X | Lodging Provider | — | NULL | — |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 251X00000X | Supports Brokerage Agency | — | NULL | — |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | — | — |
| 314000000X | Skilled Nursing Facility | — | — | Yes |
| 385H00000X | Respite Care | — | NULL | Yes |

## Other

- **Enumeration date:** 07/30/2024
- **Last updated:** 07/02/2026