| NPI | 1821633702 |
|---|---|
| Doing Business As | PORTVILLE HOME CARE SERVICES |
| Entity Type | Organization |
| Authorized Contact | YUSUFF OMOTAYO KAZZIM Chief Executive Officer 323-636-7944 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 253Z00000X In Home Supportive Care | |
| 376J00000X Homemaker | |
| 385H00000X Respite Care | |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2020-12-09 |