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General NPI Number Information
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NPI Number | 1174619324
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Entity Type | Organization
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Legal Business Name | RELIACARE, LTD
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 6900 MAIN ST SUITE 130
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-3454
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Country | US
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Telephone | 630-960-5100
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Fax | 630-960-5181
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Provider Business Mailing Address
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Address Line | 6900 MAIN ST SUITE 130
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-3454
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Country | US
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Telephone | 630-960-5100
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Fax | 630-960-5181
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Authorized Official
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Title or Position | PRESIDENT
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Name | AVANI SHAH
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Credential |
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Telephone | 630-960-5100
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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 | 1009448
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License Number State | IL
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