Healthcare Provider Details

I. General information

NPI: 1548170426
Provider Name (Legal Business Name): LAURENT FAMILY ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17906 65TH AVE
TINLEY PARK IL
60477-4245
US

IV. Provider business mailing address

17906 65TH AVE
TINLEY PARK IL
60477-4245
US

V. Phone/Fax

Practice location:
  • Phone: 765-237-7768
  • Fax:
Mailing address:
  • Phone: 765-532-4576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LAURENT AHIABLAME
Title or Position: PRESIDENT
Credential:
Phone: 765-532-4576