Healthcare Provider Details

I. General information

NPI: 1649596313
Provider Name (Legal Business Name): CENTER HOME FOR HISPANIC ELDERLY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 10/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 N CALIFORNIA AVE
CHICAGO IL
60622-1602
US

IV. Provider business mailing address

1401 N CALIFORNIA AVE
CHICAGO IL
60622-1602
US

V. Phone/Fax

Practice location:
  • Phone: 773-782-8700
  • Fax: 773-276-0465
Mailing address:
  • Phone: 773-782-8700
  • Fax: 773-276-0465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. FRANCES MEEHAN
Title or Position: ATTORNEY
Credential:
Phone: 312-521-2467