Organization
FOUNTAIN HOMECARE SERVICES LLC
Active
Other names
FOUNTAIN HOMECARE SERVICES LLC
Organization subpart
No
Provider details
NPI number
Authorized official
EBUNAYO OLORUNTELE (ADMINISTRATOR)
(818) 626-0343
Entity
Organization
Contact information
Practice address
18301 SHERMAN WAY # 13, RESEDA, CA 91335-4425
(818) 626-0343
Mailing address
13775 GLENOAKS BLVD UNIT 11, SYLMAR, CA 91342-8368
(818) 626-0343
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
11/21/2018
Last updated
11/21/2018
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