Provider Demographics
NPI:1407616451
Name:LOFTON PERSONAL CARE HOME LLC
Entity type:Organization
Organization Name:LOFTON PERSONAL CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOFTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-432-9202
Mailing Address - Street 1:2836 TOBACCO RD
Mailing Address - Street 2:
Mailing Address - City:HEPHZIBAH
Mailing Address - State:GA
Mailing Address - Zip Code:30815-7004
Mailing Address - Country:US
Mailing Address - Phone:706-432-9202
Mailing Address - Fax:762-333-8436
Practice Address - Street 1:2836 TOBACCO RD
Practice Address - Street 2:
Practice Address - City:HEPHZIBAH
Practice Address - State:GA
Practice Address - Zip Code:30815-7004
Practice Address - Country:US
Practice Address - Phone:706-432-9202
Practice Address - Fax:762-333-8436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility