Organization
LOVING LEGENDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAVONDA GREENE DHA (ADMINISTRATOR)
(951) 545-7203
Entity
Organization
Contact information
Practice address
408 E MISSION PL, CORONA, CA 92879-2829
(951) 545-7203
(626) 227-0626
Mailing address
750 S LINCOLN AVE STE 464, CORONA, CA 92882-3551
(951) 545-7203
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
07/30/2024
Last updated
07/02/2026
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