PORTVILLE GROUP (NPI# 1821633702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821633702 |
| Entity Type | Organization |
| Organization Name | PORTVILLE GROUP |
| Other Organization Name | PORTVILLE HOME CARE SERVICES |
| Practice Address |
5568 Hannibal Ct Denver CO 80239-5696 |
| Practice Telephone | 3236367944 |
| Mailing Telephone | 3236367944 |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2019-11-15 |
| Authorized Official Name | YUSUFF OMOTAYO KAZZIM (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 3236367944 |
| Is Organization Subpart | Y |
| Parent Organization Name | PORTVILLE GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Portville Home Care Services | Doing Business As Name - Organization |
| Street Address |
5568 HANNIBAL CT |
| City | DENVER |
| State | CO |
| Zip Code | 80239-5696 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437799624 | Tiffanny Edelman | Behavior Technician | 12015 E. 46th Avenue Suite 680, Denver, CO 80239 | 2020-01-15 |
| 1427543586 | Magnolia Medical Company | Clinical Medical Laboratory | 10515 40th Avenue Suite 115, Denver, CO 80239 | 2018-06-29 |
| 1124477427 | Mallory Jean Crouch | Counselor | 3720 Revere St., Ste. B, Denver, CO 80239 | 2016-06-07 |
| 1659760841 | Ebony Leanne Williams | Home Health Aide | 14976 E 50th Dr, Denver, CO 80239 | 2015-01-12 |
| 1154686301 | Tuesday Nicole Hennessy | Optometrist | 4804 N Chambers Rd, Denver, CO 80239 | 2012-07-12 |
| 1225343379 | Denver Health and Hospital Authority | Clinic/Center | 12600 E. Albrook Drive, Denver, CO 80239 | 2010-08-13 |
| 1699902114 | James Gabel Kaferly IIi | Pediatrics | 12600 East Albrook Dr., Montbello Family Health Center Office, Denver, CO 80239 | 2009-06-11 |
| 1073733218 | Health One Home Health Care LLC. | Home Health | 4890 Ironton St, Unit H6, Denver, CO 80239 | 2007-04-30 |
| 1164578993 | Chelle Marie Lodge-guttery | Psychologist | 10900 Smith Rd., Denver, CO 80239 | 2007-01-26 |
| 1952327975 | Russell Wm Simpson | Internal Medicine | 4896 Chambers Rd., Denver, CO 80239 | 2006-07-14 |
| Find all providers in zip 80239 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295105427 | Jewish Family Service of Colorado | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2310 S Holly St, Denver, CO 80222-6212 | 2015-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700419488 | Hanna Cares, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6550 S Ider St, Aurora, CO 80016-1251 | 2020-02-20 |
| 1235760521 | A Safe Place In Pagosa, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 459 Lewis Street, Pagosa Springs, CO 81147 | 2020-01-27 |
| 1649836982 | Esther House | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1051 Lima St, Aurora, CO 80010-3701 | 2019-05-13 |
| 1730742297 | Mesa Developmental Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 309 Kava Way, Grand Junction, CO 81503-3153 | 2019-04-19 |
| 1013570571 | Mesa Developmental Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3301 Laurel Ln, Clifton, CO 81520-8123 | 2019-04-19 |
| 1083106744 | Jon W. Baker Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3835 Mckay Rd, Colorado Springs, CO 80906-5707 | 2018-05-30 |
| 1710483714 | Lighthouse Residenital | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10200 W 44th Ave Ste 400b, Wheat Ridge, CO 80033-6826 | 2018-03-30 |
| 1952816795 | Sozo Sss International LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6324 S Sicily Way, Aurora, CO 80016-7009 | 2017-12-01 |
| 1457875999 | Sandra Douglas | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3109 66th Ave, Greeley, CO 80634-8932 | 2017-07-26 |
| 1356876700 | Our Family Care Home Assisted Living LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1169 Johnson Street, Lakewood, CO 80215 | 2017-04-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.