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General NPI Number Information
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NPI Number | 1457667305
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Entity Type | Organization
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Legal Business Name | COMPLETE HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 08/28/2010
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Last Update Date | 08/28/2010
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Provider Practice Location Address
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Address Line | 2800 S WENTWORTH AVE
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City | CHICAGO
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State | IL
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Zip | 60616-4766
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Country | US
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Telephone | 773-814-1672
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Fax | 312-808-1288
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Provider Business Mailing Address
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Address Line | 2800 S WENTWORTH AVE
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City | CHICAGO
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State | IL
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Zip | 60616-4766
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Country | US
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Telephone | 773-814-1672
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Fax | 312-808-1288
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Authorized Official
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Title or Position | AGENCY SUPERVISOR
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Name | MISS LILY YUEN
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Credential | R.N.
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Telephone | 773-814-1672
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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 | 1011213
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License Number State | IL
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