=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316970635
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARING COMMUNITY HOME HEALTH, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/09/2006
-----------------------------------------------------
Last Update Date | 12/05/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 494 W BOUGHTON RD STE 3
-----------------------------------------------------
City | BOLINGBROOK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60440-1881
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-759-2718
-----------------------------------------------------
Fax | 630-759-2654
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 494 W BOUGHTON RD STE 3
-----------------------------------------------------
City | BOLINGBROOK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60440-1881
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-759-2718
-----------------------------------------------------
Fax | 630-759-2654
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MS. JANET HART
-----------------------------------------------------
Credential | ADMINISTRATOR
-----------------------------------------------------
Telephone | 630-999-6812
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 1010611
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------