Portsmouth Senior Home LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PORTSMOUTH SENIOR HOME LLC

Practice address

28611 Portsmouth Dr
Menifee, CA 92586-2658

Phone

(951) 309-1158

NPI assigned

Nov 5, 2025

Organization subpart

No

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

Authorized official

Name

Jamie Fides Lao

Title

Licensee

Phone

(951) 309-1158

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1762300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762300800000",
    "number": "1629948641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 E LURAY ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908071020",
            "telephone_number": "951-309-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28611 PORTSMOUTH DR",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925862658",
            "telephone_number": "951-309-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTSMOUTH SENIOR HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-05",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A",
        "authorized_official_last_name": "LAO",
        "authorized_official_first_name": "JAMIE FIDES",
        "authorized_official_title_or_position": "LICENSEE",
        "authorized_official_telephone_number": "951-309-1158"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Menifee, CA
• Providers in Menifee, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; 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.