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General NPI Number Information
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NPI Number | 1811555071
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Entity Type | Organization
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Legal Business Name | KELLY HOME HEALTHCARE, INC
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Dates
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Enumeration Date | 06/03/2019
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Last Update Date | 06/03/2019
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Provider Practice Location Address
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Address Line | 3325 183RD ST
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City | HOMEWOOD
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State | IL
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Zip | 60430-2602
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Country | US
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Telephone | 708-991-2776
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Fax | 708-960-0419
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Provider Business Mailing Address
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Address Line | 3325 183RD ST
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City | HOMEWOOD
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State | IL
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Zip | 60430-2602
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Country | US
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Telephone | 708-991-2776
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Fax | 708-960-0419
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Authorized Official
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Title or Position | PRESIDENT
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Name | NNEKA GREEN
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Credential |
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Telephone | 708-960-0252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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