=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013929124
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARE FOR LIFE HOME HEALTH INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/13/2006
-----------------------------------------------------
Last Update Date | 03/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 182 MELROSE AVE STE 1
-----------------------------------------------------
City | SOUTH ELGIN
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60177-1646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-214-3633
-----------------------------------------------------
Fax | 847-214-3634
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 182 MELROSE AVE STE 1
-----------------------------------------------------
City | SOUTH ELGIN
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60177-1646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-214-3633
-----------------------------------------------------
Fax | 847-214-3634
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MRS. MIA PACHECO
-----------------------------------------------------
Credential | R.N.
-----------------------------------------------------
Telephone | 847-624-2594
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 1010550
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------