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General NPI Number Information
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NPI Number | 1659316339
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Entity Type | Organization
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Legal Business Name | INSTITUTE OF FAMILY CARE
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 417 S PIERPONT AVE
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City | ROCKFORD
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State | IL
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Zip | 61102-1656
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Country | US
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Telephone | 815-963-1596
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Fax |
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Provider Business Mailing Address
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Address Line | 417 S PIERPONT AVE
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City | ROCKFORD
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State | IL
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Zip | 61102-1656
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Country | US
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Telephone | 815-963-1596
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Fax |
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Authorized Official
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Title or Position | SOCIAL SERVICES
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Name | MS. WANDA JUNE BUCHANAN
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Credential | B.A.
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Telephone | 815-963-1596
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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 |
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