Portville Group

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

PORTVILLE GROUP

Practice address

5568 Hannibal CT
Denver, CO 80239-5696

Phone

(323) 636-7944

NPI assigned

Nov 14, 2019

Organization subpart

Yes

Parent organization

PORTVILLE GROUPAs reported in NPPES

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

Authorized official

Name

Yusuff Omotayo Kazzim

Title

Chief Executive Officer

Phone

(323) 636-7944

Specialties & licenses 5

Addresses

Other names 1

• Portville Home Care Services Doing business as

Part of

Portville Group

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607472000000",
    "number": "1821633702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5568 HANNIBAL CT",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802395696",
            "telephone_number": "323-636-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5568 HANNIBAL CT",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802395696",
            "telephone_number": "323-636-7944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTVILLE GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PORTVILLE GROUP",
        "enumeration_date": "2019-11-14",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A",
        "authorized_official_last_name": "KAZZIM",
        "authorized_official_first_name": "YUSUFF",
        "authorized_official_middle_name": "OMOTAYO",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "323-636-7944"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portville Home Care Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roxanne Marie Porterfield, RN
• Alicia Portillo, RN
• Herlinda Ruby Portillo
• Jacqueline N Portillo
• Norman W Portnoy, PH.D.
• Gabrielle Nicole Porzenski, DO
• Poseidon Therapy
• Posha Zubair LCSW, LLC
• Positive Behavior Outcomes
• Positive Health Chiropractic, LLC

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Denver, CO
• Providers in Denver, CO by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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.