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General NPI Number Information
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NPI Number | 1417039116
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Entity Type | Organization
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Legal Business Name | DEACONESS VNA PLUS, LLC
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 05/14/2015
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Provider Practice Location Address
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Address Line | 1300 US HIGHWAY 45 N
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City | ELDORADO
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State | IL
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Zip | 62930-3765
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Country | US
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Telephone | 618-273-9305
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Fax | 618-273-2469
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Provider Business Mailing Address
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Address Line | 1300 US HIGHWAY 45 N
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City | ELDORADO
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State | IL
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Zip | 62930-3765
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Country | US
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Telephone | 618-273-9305
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Fax | 618-273-2469
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. GLORIA D HORTON
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Credential |
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Telephone | 812-425-3561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1011757
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License Number State | IL
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