Provider Demographics
NPI:1235724493
Name:MYPREFERENCE HOMECARE SERVICES LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:MYPREFERENCE HOMECARE SERVICES LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FOLASHADE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUTUNMBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-870-7158
Mailing Address - Street 1:154 WENTWORTH CIR
Mailing Address - Street 2:
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-1641
Mailing Address - Country:US
Mailing Address - Phone:716-870-7158
Mailing Address - Fax:
Practice Address - Street 1:276 OLD MILL RD
Practice Address - Street 2:
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-2720
Practice Address - Country:US
Practice Address - Phone:716-870-7158
Practice Address - Fax:610-474-2342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care