Healthcare Provider Details

I. General information

NPI: 1639807795
Provider Name (Legal Business Name): ALTO HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2022
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15928 VENTURA BLVD. SUITE 211
ENCINO CA
91436-4400
US

IV. Provider business mailing address

15928 VENTURA BLVD. SUITE 211
ENCINO CA
91436-4400
US

V. Phone/Fax

Practice location:
  • Phone: 818-808-8046
  • Fax: 818-280-8118
Mailing address:
  • Phone: 818-808-8046
  • Fax: 818-280-8118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. DARRYL LEE MARKOWSKI
Title or Position: CFO
Credential:
Phone: 415-613-9573