Healthcare Provider Details
I. General information
NPI: 1003879552
Provider Name (Legal Business Name): ADDUS HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/07/2006
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1800 SUTTER ST STE 360
CONCORD CA
94520
US
IV. Provider business mailing address
2401 S PLUM GROVE RD
PALATINE IL
60067
US
V. Phone/Fax
- Phone: 925-671-4100
- Fax: 925-356-2889
- Phone: 847-303-5300
- Fax: 847-303-5376
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | 020000226 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251F00000X |
| Taxonomy | Home Infusion Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
DIANE
KUMARICH
Title or Position: NATIONAL CONTRACTS
Credential: RN, MS, MBA
Phone: 847-303-5300