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General NPI Number Information
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NPI Number | 1316644552
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Entity Type | Organization
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Legal Business Name | VENTRACARE HOMES INC
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Dates
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Enumeration Date | 02/08/2023
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 11025 RIDGELAND AVE
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City | CHICAGO RIDGE
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State | IL
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Zip | 60415-2492
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Country | US
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Telephone | 708-953-1476
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Fax | 800-990-3770
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Provider Business Mailing Address
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Address Line | 1440 ASTER LN
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City | BOLINGBROOK
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State | IL
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Zip | 60490-4532
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Country | US
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Telephone | 708-953-1476
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Fax | 800-990-3770
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. SALLY A NWAFOR
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Credential | PH.D
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Telephone | 708-953-1476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number |
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License Number State |
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