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General NPI Number Information
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NPI Number | 1619317864
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Entity Type | Organization
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Legal Business Name | IMPULSE HOME HEALTH INC.
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Dates
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Enumeration Date | 07/02/2013
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Last Update Date | 07/02/2013
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Provider Practice Location Address
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Address Line | 684 W BOUGHTON RD SUITE 204
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City | BOLINGBROOK
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State | IL
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Zip | 60440-1781
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Country | US
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Telephone | 630-226-2303
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Fax | 630-226-2304
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Provider Business Mailing Address
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Address Line | 684 W BOUGHTON RD SUITE 204
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City | BOLINGBROOK
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State | IL
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Zip | 60440-1781
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Country | US
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Telephone | 630-226-2303
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Fax | 630-226-2304
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. CARMELO PARANAL
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Credential |
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Telephone | 630-226-2303
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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 | 1011533
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License Number State | IL
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