Organization
LONGEVITY CARE PROVIDERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. IVA MURIAL STANLEY RN (PRESIDENT/CEO)
(805) 896-7594
Entity
Organization
Contact information
Practice address
175 MCMURRAY RD STE H, BUELLTON, CA 93427-9576
(805) 896-7594
(805) 686-9140
Mailing address
175 MCMURRAY RD STE H, BUELLTON, CA 93427-9576
(805) 896-7594
(805) 686-9140
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1271242752P381E381
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1271242752P381E381
EDD
CA
Enumeration date
05/24/2016
Last updated
05/24/2016
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