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General NPI Number Information
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NPI Number | 1710958533
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Entity Type | Organization
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Legal Business Name | HOME BOUND HEALTHCARE, INC.
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 02/01/2017
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Provider Practice Location Address
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Address Line | 14216 MCCARTHY RD UNIT A
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City | LEMONT
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State | IL
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Zip | 60439-9393
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Country | US
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Telephone | 708-798-0800
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Fax | 708-798-0870
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Provider Business Mailing Address
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Address Line | 14216 MCCARTHY RD UNIT A
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City | LEMONT
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State | IL
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Zip | 60439-9393
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Country | US
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Telephone | 708-798-0800
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Fax | 708-798-0870
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Authorized Official
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Title or Position | PRESIDENT/SECRETARY/TREASURER
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Name | MRS. JULIETA MITRA JR.
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Credential |
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Telephone | 708-798-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 14D1036623
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1010413
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1011897
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License Number State | IL
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