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General NPI Number Information
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NPI Number | 1699343129
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Entity Type | Organization
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Legal Business Name | SPECIAL HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 06/11/2021
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Last Update Date | 06/11/2021
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Provider Practice Location Address
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Address Line | 13303 S RIDGELAND AVE UNIT C
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-0020
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Country | US
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Telephone | 815-595-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 PLAINFIELD RD
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City | JOLIET
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State | IL
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Zip | 60435-1902
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT/ALT MANAGER
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Name | WOROOD DOLEH
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Credential |
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Telephone | 708-262-0562
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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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