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General NPI Number Information
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NPI Number | 1366469231
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Entity Type | Organization
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Legal Business Name | GENERATIONS HEALTHCARE, LLC
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2 WESTBROOK CORPORATE CTR STE 320
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City | WESTCHESTER
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State | IL
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Zip | 60154-5721
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Country | US
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Telephone | 708-409-3040
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Fax | 708-409-3041
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Provider Business Mailing Address
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Address Line | 2 WESTBROOK CORPORATE CTR STE 320
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City | WESTCHESTER
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State | IL
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Zip | 60154-5721
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Country | US
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Telephone | 708-409-3040
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Fax | 708-409-3041
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Authorized Official
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Title or Position | VICE PRESIDENT/COO
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Name | MRS. CATHY PONAKALA
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Credential | LMSW
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Telephone | 708-409-3040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State | IL
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