=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730331737
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADDUS HEALTH CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/21/2008
-----------------------------------------------------
Last Update Date | 04/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 420 W GAINES ST STE 1
-----------------------------------------------------
City | MONTICELLO
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 71655-4724
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-412-4141
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 801 WARRENVILLE RD STE 800
-----------------------------------------------------
City | LISLE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60532-0912
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-296-3400
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EVP CGRO
-----------------------------------------------------
Name | DARBY ANDERSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 630-296-3400
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------