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NPI Code Detail

MEDICARE: RIVER LEE HOME CARE SERVICES LLC

MEDICARE: RIVER LEE HOME CARE SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1760236798
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVER LEE HOME CARE SERVICES LLC
Provider Business Mailing Address
First Line : 7777 W LINCOLN HWY
Second Line :
City : FRANKFORT
State : IL
Zip : 60423-9490
Country : US
Telephone Number : 773-896-7914
Fax Number :
Provider Business Practice Location Address
First Line : 7777 W LINCOLN HWY
Second Line :
City : FRANKFORT
State : IL
Zip : 60423-9490
Country : US
Telephone Number : 773-896-7914
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DISHAIVIA ADAMS
Credential :
Telephone Number : 773-896-7914
Provider Enumeration Date : 04/16/2024
Last Update Date : 04/16/2024

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Directions to “RIVER LEE HOME CARE SERVICES LLC ” Practice Location

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