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General NPI Number Information
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NPI Number | 1508562851
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Entity Type | Organization
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Legal Business Name | CONTRACT NURSING LLC
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Dates
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Enumeration Date | 02/07/2023
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 7220 S SOUTH SHORE DR APT 406
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City | CHICAGO
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State | IL
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Zip | 60649-2751
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Country | US
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Telephone | 312-774-5315
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Fax |
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Provider Business Mailing Address
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Address Line | 7220 S SOUTH SHORE DR APT 406
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City | CHICAGO
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State | IL
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Zip | 60649-2751
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Country | US
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Telephone | 312-774-3153
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MAURICE PUOMAAYE KONTA
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Credential | RN-MSN
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Telephone | 131-277-4531
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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