Healthcare Provider Details

I. General information

NPI: 1255769865
Provider Name (Legal Business Name): ADDUS HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2013
Last Update Date: 11/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2129 OSUNA RD NE STE 100B
ALBUQUERQUE NM
87113-7001
US

IV. Provider business mailing address

2300 WARRENVILLE RD SUITE 100
DOWNERS GROVE IL
60515-1765
US

V. Phone/Fax

Practice location:
  • Phone: 505-792-8230
  • Fax: 855-890-3021
Mailing address:
  • Phone: 630-296-3400
  • Fax: 630-487-2713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number0000
License Number StateNM

VIII. Authorized Official

Name: MS. DIANE KUMARICH
Title or Position: NATIONAL CONTRACTS
Credential: RN, MS, MBA
Phone: 630-296-3400