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General NPI Number Information
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NPI Number | 1477488146
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Entity Type | Organization
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Legal Business Name | WALTER'S HOME CARE AGENCY LLC
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Dates
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Enumeration Date | 06/15/2026
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Last Update Date | 06/15/2026
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Provider Practice Location Address
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Address Line | 15 W HARRIS AVE STE 15
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City | LA GRANGE
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State | IL
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Zip | 60525-2368
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Country | US
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Telephone | 773-673-1211
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Fax |
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Provider Business Mailing Address
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Address Line | 15 W HARRIS AVE STE 15
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City | LA GRANGE
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State | IL
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Zip | 60525-2368
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Country | US
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Telephone | 773-673-1211
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TINA M GENTRY
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Credential | GENTRY
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Telephone | 773-673-1211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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