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General NPI Number Information
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NPI Number | 1588930549
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Entity Type | Organization
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Legal Business Name | A&V HOMECARE SERVICES, INC.
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Dates
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Enumeration Date | 03/23/2012
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 15000 CICERO AVE STE 2E
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City | OAK FOREST
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State | IL
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Zip | 60452-1481
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Country | US
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Telephone | 708-535-4388
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Fax | 708-535-8221
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Provider Business Mailing Address
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Address Line | 15000 CICERO AVE STE 2E
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City | OAK FOREST
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State | IL
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Zip | 60452-1481
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Country | US
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Telephone | 708-535-4388
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Fax | 708-535-8221
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. VICTOR OLUDARE SHOLANKE
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Credential | MSW, MS, QIDP
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Telephone | 708-535-4388
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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 | IL
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State | IL
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Taxonomy #3
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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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