Organization
LOYAL FIJIAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAKERETA LEDUA HERESFORD I (CEO/MANAGER)
(707) 774-9186
Entity
Organization
Contact information
Practice address
78 CARLETON DR, PETALUMA, CA 94952-2254
(707) 774-9186
Mailing address
78 CARLETON DR, PETALUMA, CA 94952-2254
(707) 774-9186
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
11/13/2023
Last updated
01/31/2024
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