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General NPI Number Information
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NPI Number | 1356007728
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Entity Type | Organization
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Legal Business Name | PRIME HOME HEALTHCARE SERVICES, LLC
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Dates
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Enumeration Date | 11/10/2021
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Last Update Date | 11/10/2021
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Provider Practice Location Address
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Address Line | 7238 N BELL AVE
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City | CHICAGO
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State | IL
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Zip | 60645-2004
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Country | US
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Telephone | 312-690-9087
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Fax |
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Provider Business Mailing Address
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Address Line | 7238 N BELL AVE
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City | CHICAGO
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State | IL
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Zip | 60645-2004
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Country | US
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Telephone | 312-690-9087
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. SOLOMON B. BADA
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Credential |
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Telephone | 312-690-9087
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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