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General NPI Number Information
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NPI Number | 1780985580
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Entity Type | Organization
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Legal Business Name | FAVOR IN THE LAND
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Dates
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Enumeration Date | 11/10/2010
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Last Update Date | 11/10/2010
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Provider Practice Location Address
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Address Line | 150 N MASON AVE SUITE 1
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City | CHICAGO
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State | IL
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Zip | 60644-2801
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Country | US
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Telephone | 131-231-5074
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Fax |
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Provider Business Mailing Address
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Address Line | 150 N MASON AVE SUITE 1
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City | CHICAGO
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State | IL
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Zip | 60644-2801
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Country | US
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Telephone | 131-231-5074
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALFREDA THOMPSON
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Credential |
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Telephone | 13123150748
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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 | 1916239
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License Number State | IL
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