Loyal Service Agency Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

3351 Issued in NM

Legal business name

LOYAL SERVICE AGENCY INC.

Practice address

103 Goltz Dr
Grants, NM 87020-2155

Phone

(505) 285-2966

Fax

(505) 285-4055

NPI assigned

Aug 29, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Lonnel M Sandoval-Asebedo, R.N.

Title

Owner

Phone

(505) 285-2966

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409270400000",
    "number": "1033519897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 GOLTZ DR",
            "city": "GRANTS",
            "state": "NM",
            "postal_code": "870202155",
            "telephone_number": "505-285-2966",
            "fax_number": "505-285-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 GOLTZ DR",
            "city": "GRANTS",
            "state": "NM",
            "postal_code": "870202155",
            "telephone_number": "505-285-2966",
            "fax_number": "505-285-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOYAL SERVICE AGENCY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-29",
        "last_updated": "2014-08-29",
        "status": "A",
        "authorized_official_last_name": "SANDOVAL-ASEBEDO",
        "authorized_official_first_name": "LONNEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-285-2966",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NM",
            "license": "3351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.