Healthcare Provider Details

I. General information

NPI: 1619930161
Provider Name (Legal Business Name): ADDUS HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 10/05/2021
Certification Date: 10/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 INDUSTRIAL PARK ROAD STE, C
SANTA FE NM
87506
US

IV. Provider business mailing address

2300 WARRENVILLE RD STE 100
DOWNERS GROVE IL
60515-1717
US

V. Phone/Fax

Practice location:
  • Phone: 505-753-2284
  • Fax: 855-893-0646
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 Number6759
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number85R76
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DARBY ANDERSON
Title or Position: EVP, CHIEF STRATEGY OFFICER
Credential:
Phone: 630-296-3591