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General NPI Number Information
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NPI Number | 1467973537
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Entity Type | Organization
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Legal Business Name | FRIENDS OVER FIFTY SENIOR CARE, INC.
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 349 S WEBER RD STE 129
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City | ROMEOVILLE
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State | IL
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Zip | 60446-6542
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Country | US
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Telephone | 815-836-2635
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Fax | 708-668-4187
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Provider Business Mailing Address
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Address Line | 349 S WEBER RD STE 129
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City | ROMEOVILLE
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State | IL
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Zip | 60446-6542
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Country | US
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Telephone | 815-836-2635
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Fax | 708-668-4187
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | LAURA A NOVAK
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Credential |
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Telephone | 815-836-2635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | IL
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