Organization
PA HOME MODIFICATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN PORTIS (OWNER)
(412) 607-4400
Entity
Organization
Contact information
Practice address
3904 PERRYSVILLE AVE, PITTSBURGH, PA 15214-1748
(412) 607-4400
Mailing address
3904 PERRYSVILLE AVE, PITTSBURGH, PA 15214-1748
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
HOME ADAPTION
—
Enumeration date
04/29/2019
Last updated
04/29/2019
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