Healthcare Provider Details

I. General information

NPI: 1982076329
Provider Name (Legal Business Name): CROSS COUNTRY HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2015
Last Update Date: 10/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N WALL ST STE 308
KANKAKEE IL
60901-2940
US

IV. Provider business mailing address

400 N WALL ST STE 308
KANKAKEE IL
60901-2940
US

V. Phone/Fax

Practice location:
  • Phone: 815-937-7962
  • Fax:
Mailing address:
  • Phone: 815-937-7962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TERRIL APPLEWHITE
Title or Position: OWNER
Credential: MD
Phone: 815-937-7962