# FOUNTAIN HOMECARE SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FOUNTAIN HOMECARE SERVICES LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245709187
- **Authorized official:** EBUNAYO OLORUNTELE (ADMINISTRATOR)
- **Authorized official phone:** (818) 626-0343

## Contact information

- **Practice address:** 18301 SHERMAN WAY \# 13, RESEDA, CA 91335-4425
- **Practice address phone:** (818) 626-0343
- **Mailing address:** 13775 GLENOAKS BLVD UNIT 11, SYLMAR, CA 91342-8368
- **Mailing address phone:** (818) 626-0343

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 11/21/2018
- **Last updated:** 11/21/2018