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General NPI Number Information
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NPI Number | 1194911636
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Entity Type | Organization
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Legal Business Name | COMMUNITY CARE HOME HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 03/11/2009
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Provider Practice Location Address
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Address Line | 10001 DERBY LN SUITE 207
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City | WESTCHESTER
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State | IL
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Zip | 60154-2600
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Country | US
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Telephone | 708-410-2605
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Fax | 708-410-2601
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Provider Business Mailing Address
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Address Line | 10001 DERBY LN SUITE 207
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City | WESTCHESTER
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State | IL
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Zip | 60154-3749
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Country | US
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Telephone | 708-410-2605
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Fax | 708-410-2601
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MARYLIZA LORENZO
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Credential | RN
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Telephone | 708-410-2605
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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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