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General NPI Number Information
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NPI Number | 1417397795
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Entity Type | Organization
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Legal Business Name | A SPECIAL FRIEND HOME HEALTHCARE AGENCY
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Dates
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Enumeration Date | 07/01/2013
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Last Update Date | 07/01/2013
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Provider Practice Location Address
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Address Line | 1647 S BLUE ISLAND AVE 2ND FL
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City | CHICAGO
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State | IL
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Zip | 60608-2133
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Country | US
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Telephone | 312-772-6469
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Fax | 773-888-3091
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Provider Business Mailing Address
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Address Line | 1647 S BLUE ISLAND AVE 2ND FL
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City | CHICAGO
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State | IL
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Zip | 60608-2133
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Country | US
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Telephone | 312-772-6469
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Fax | 773-888-3091
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Authorized Official
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Title or Position | CEO
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Name | CAROL ANN REED
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Credential |
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Telephone | 312-772-6469
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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 | 041371679
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License Number State | IL
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