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General NPI Number Information
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NPI Number | 1093041360
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Entity Type | Organization
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Legal Business Name | BEVERLY HOME HEALTH CARE, INC.
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Dates
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Enumeration Date | 10/21/2009
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Last Update Date | 11/28/2012
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Provider Practice Location Address
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Address Line | 2045 S. ARLINGTON HEIGHTS ROAD, 1STE 116
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-1499
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Country | US
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Telephone | 708-583-1626
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Fax | 708-221-7196
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Provider Business Mailing Address
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Address Line | 2045 S. ARLINGTON HEIGHTS ROAD STE 116
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-1499
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Country | US
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Telephone | 708-583-1626
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Fax | 708-221-7196
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Authorized Official
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Title or Position | PRESIDENT/SECRETARY
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Name | MS. ROSITA CUYUGAN TRI NIDAD
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Credential |
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Telephone | 708-583-1626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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