Healthcare Provider Details

I. General information

NPI: 1497676225
Provider Name (Legal Business Name): KLOVER HOMES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17484 PARK LN
COUNTRY CLUB HILLS IL
60478-4686
US

IV. Provider business mailing address

18505 BELLAMY RD
COUNTRY CLUB HILLS IL
60478-5279
US

V. Phone/Fax

Practice location:
  • Phone: 708-712-5766
  • Fax:
Mailing address:
  • Phone: 708-712-5766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CHARITY HARDISON
Title or Position: OWNER
Credential:
Phone: 708-712-5766