=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043532880
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABLING HANDS HOME HEALTH SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2010
-----------------------------------------------------
Last Update Date | 02/22/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 804 SHERIDAN RD
-----------------------------------------------------
City | PEKIN
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61554-1629
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 309-938-4468
-----------------------------------------------------
Fax | 309-282-8730
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 804 SHERIDAN RD
-----------------------------------------------------
City | PEKIN
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61554-1629
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 309-938-4468
-----------------------------------------------------
Fax | 309-282-8730
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | JENNIFER J DIXON
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 309-202-2791
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 1011252
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------