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General NPI Number Information
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NPI Number | 1326152067
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Entity Type | Organization
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Legal Business Name | WESTERN ILLINOIS MANAGED HOME SERVICES, INC.
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1197 N HENDERSON ST SUITE 1
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City | GALESBURG
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State | IL
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Zip | 61401-2574
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Country | US
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Telephone | 309-342-3516
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Fax | 309-342-2312
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Provider Business Mailing Address
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Address Line | 1197 N HENDERSON ST SUITE 1
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City | GALESBURG
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State | IL
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Zip | 61401-2574
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Country | US
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Telephone | 309-342-3516
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Fax | 309-342-2312
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. BARBARA A BYERS
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Credential |
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Telephone | 309-342-3516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 2006-N0395
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License Number State | IL
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