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General NPI Number Information
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NPI Number | 1093741415
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Entity Type | Organization
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Legal Business Name | REGENCY HOME HEALTH CARE, P.C.
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 03/16/2010
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Provider Practice Location Address
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Address Line | 10448 S PULASKI RD SUITE 4
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City | OAK LAWN
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State | IL
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Zip | 60453-4895
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Country | US
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Telephone | 708-952-1052
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Fax | 708-952-1053
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Provider Business Mailing Address
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Address Line | 6060 W. 95TH STREET
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City | OAK LAWN
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State | IL
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Zip | 60453-2778
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Country | US
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Telephone | 708-398-4022
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | AHMED MOHAMED
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Credential | P.T.
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Telephone | 708-398-4022
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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 | 070-007492
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1010758
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License Number State | IL
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