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General NPI Number Information
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NPI Number | 1639333016
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Entity Type | Organization
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Legal Business Name | VWELL WEST, INC.
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Dates
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Enumeration Date | 07/15/2008
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Last Update Date | 08/29/2018
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Provider Practice Location Address
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Address Line | 1601 BOND ST SUITE 210
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City | NAPERVILLE
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State | IL
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Zip | 60563
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Country | US
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Telephone | 888-258-9355
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Fax | 630-369-6984
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Provider Business Mailing Address
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Address Line | 1717 HOWARD ST
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City | EVANSTON
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State | IL
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Zip | 60202-3735
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Country | US
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Telephone | 888-258-9355
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Fax | 630-369-6984
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Authorized Official
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Title or Position | CLINICAL OPERATIONS EXECUTIVE
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Name | MR. ALLAN DENNIS ROSALES
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Credential |
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Telephone | 312-989-9260
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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 | HHA4404
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License Number State | AZ
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