Healthcare Provider Details
I. General information
NPI: 1295264687
Provider Name (Legal Business Name): ALAGA HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/08/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
875 N. MICHIGAN AVENUE 31ST FLOOR
CHICAGO IL
60611
US
IV. Provider business mailing address
875 N MICHIGAN AVE FL 31
CHICAGO IL
60611-1962
US
V. Phone/Fax
- Phone: 312-667-4646
- Fax:
- Phone: 312-667-4646
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 372500000X |
| Taxonomy | Chore Provider |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374U00000X |
| Taxonomy | Home Health Aide |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376J00000X |
| Taxonomy | Homemaker |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376K00000X |
| Taxonomy | Nurse's Aide |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MIMILANIE
MEDALLE
CERALDE
Title or Position: CO-FOUNDER
Credential:
Phone: 312-667-4646