Organization
PUBLIC IN-HOME SUPPORT SERVICES AUTHORITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN HUNTER JR. (ADMINISTRATOR)
(305) 923-8312
Entity
Organization
Contact information
Practice address
9325 APPLETON ST # 79, VICTORVILLE, CA 92392-1843
(310) 283-6720
Mailing address
32295 MISSION TRL # 8-312, LAKE ELSINORE, CA 92530-2305
(305) 923-8312
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
02/03/2022
Last updated
02/03/2022
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