Healthcare Provider Details
I. General information
NPI: 1881462927
Provider Name (Legal Business Name): SHREEJI HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/18/2023
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1100 33RD ST
ZION IL
60099-3600
US
IV. Provider business mailing address
1100 33RD ST
ZION IL
60099-3600
US
V. Phone/Fax
- Phone: 952-201-5137
- Fax:
- Phone: 952-201-5137
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332U00000X |
| Taxonomy | Home Delivered Meals |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHVETA
PATEL
Title or Position: PRESIDENT
Credential:
Phone: 952-201-5137