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General NPI Number Information
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NPI Number | 1558631887
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Entity Type | Organization
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Legal Business Name | SALUD Y VIDA HEALTH CARE LLC
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Dates
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Enumeration Date | 01/03/2012
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Last Update Date | 07/01/2013
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Provider Practice Location Address
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Address Line | 3336 W LAWRENCE AVE STE 302
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City | CHICAGO
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State | IL
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Zip | 60625-5212
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Country | US
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Telephone | 773-509-5656
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Fax | 773-509-5830
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Provider Business Mailing Address
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Address Line | 3336 W LAWRENCE AVE STE 302
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City | CHICAGO
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State | IL
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Zip | 60625-5212
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Country | US
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Telephone | 773-509-5656
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Fax | 773-509-5830
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. CINDY ELIZABETH VALENCIA
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Credential | RN
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Telephone | 773-509-5656
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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 | 1011466
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License Number State | IL
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