Fountain Homecare Services LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

FOUNTAIN HOMECARE SERVICES LLC

Practice address

18301 Sherman Way # 13
Reseda, CA 91335-4425

Phone

(818) 626-0343

NPI assigned

Nov 21, 2018

Organization subpart

No

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

Authorized official

Name

Ebunayo Oloruntele

Title

Administrator

Phone

(818) 626-0343

Specialties & licenses 1

Addresses

Other names 1

• FOUNTAIN HOMECARE SERVICES LLC Former legal business name

Locations

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542758400000",
    "number": "1245709187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13775 GLENOAKS BLVD UNIT 11",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913428368",
            "telephone_number": "818-626-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18301 SHERMAN WAY # 13",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354425",
            "telephone_number": "818-626-0343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN HOMECARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-21",
        "last_updated": "2018-11-21",
        "status": "A",
        "authorized_official_last_name": "OLORUNTELE",
        "authorized_official_first_name": "EBUNAYO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-626-0343"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOUNTAIN HOMECARE SERVICES LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• In Home Supportive Care Agency in Reseda, CA
• Providers in Reseda, CA by specialty
• In Home Supportive Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; 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.