Healthcare Provider Details

I. General information

NPI: 1366608754
Provider Name (Legal Business Name): PRAC HOLDINGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2008
Last Update Date: 11/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 BELMONT CTR DR NE STE 400
BELMONT MI
49306-8702
US

IV. Provider business mailing address

2300 WARRENVILLE RD., STE 100
DOWNERS GROVE IL
60515-1765
US

V. Phone/Fax

Practice location:
  • Phone: 616-735-4506
  • Fax:
Mailing address:
  • Phone: 630-296-3530
  • 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: DIANE KUMARICH
Title or Position: VP NATIONAL CONTRACTS
Credential: RN, MS, MBA
Phone: 630-296-3400