=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750869244
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ACCESS ONE HOME CARE SERVICES INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/06/2018
-----------------------------------------------------
Last Update Date | 08/06/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24150 MATTHEW PL
-----------------------------------------------------
City | SANTA CLARITA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91321-4690
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-881-1136
-----------------------------------------------------
Fax | 818-279-2119
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 24150 MATTHEW PL
-----------------------------------------------------
City | SANTA CLARITA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91321-4690
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-881-1136
-----------------------------------------------------
Fax | 818-279-2119
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | YEMI OGUNTOLU
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-881-1136
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------