Healthcare Provider Details

I. General information

NPI: 1447695853
Provider Name (Legal Business Name): ECUMENICAL SUPPORT SERVICES FOR THE ELDERLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2013
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 S WHEATON AVE
WHEATON IL
60187-5213
US

IV. Provider business mailing address

515 S. WHEATON AVE.
WHEATON IL
60187
US

V. Phone/Fax

Practice location:
  • Phone: 630-260-3773
  • Fax: 630-260-8046
Mailing address:
  • Phone: 630-260-3773
  • Fax: 630-260-8046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. CATHY C DAVIT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 630-260-3773