Organization
PROTECTIVE HOME CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBY P BONGAM (MEMBER)
(786) 451-5184
Entity
Organization
Contact information
Practice address
7600 GEORGIA AVE NW STE 412, WASHINGTON, DC 20012-1616
(202) 940-3604
Mailing address
7600 GEORGIA AVE NW STE 412, WASHINGTON, DC 20012-1616
(786) 451-5184
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
06/14/2021
Last updated
10/25/2021
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