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General NPI Number Information
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NPI Number | 1154585040
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Entity Type | Organization
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Legal Business Name | HOME BOUND HEALTHCARE, INC.
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 09/24/2008
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Provider Practice Location Address
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Address Line | 421 S GRAND AVE W SUITE 2B
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City | SPRINGFIELD
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State | IL
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Zip | 62704-3781
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Country | US
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Telephone | 217-753-2260
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Fax | 217-753-2270
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Provider Business Mailing Address
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Address Line | 421 SOUTH GRAND AVE W SUITE 2B
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City | SPRINGFIELD
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State | IL
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Zip | 62704-3781
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Country | US
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Telephone | 217-753-2260
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Fax | 217-753-2270
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. ANDREA J MILLER
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Credential | LNHA
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Telephone | 217-753-2260
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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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