Provider Demographics
NPI:1760665137
Name:PROFESSIONAL HOME CARE SERVICES
Entity Type:Organization
Organization Name:PROFESSIONAL HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:SNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-256-3139
Mailing Address - Street 1:16370 NE THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-5542
Mailing Address - Country:US
Mailing Address - Phone:503-256-3139
Mailing Address - Fax:
Practice Address - Street 1:16370 NE THOMPSON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-5542
Practice Address - Country:US
Practice Address - Phone:503-256-3139
Practice Address - Fax:503-256-4661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-08
Last Update Date:2007-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care