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General NPI Number Information
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NPI Number | 1558310540
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Entity Type | Organization
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Legal Business Name | RIGHT AT HOME OF ILLIANA, INC.
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1402 E MAIN ST
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City | DANVILLE
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State | IL
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Zip | 61832-5057
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Country | US
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Telephone | 217-709-0160
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Fax |
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Provider Business Mailing Address
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Address Line | 1402 E MAIN ST
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City | DANVILLE
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State | IL
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Zip | 61832-5057
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Country | US
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Telephone | 217-709-0160
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & OWNER
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Name | RONALD MACK
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Credential | CSA, CMSA
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Telephone | 217-709-0160
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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 | 2006-N0899
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License Number State | IL
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