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General NPI Number Information
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NPI Number | 1841094513
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Entity Type | Organization
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Legal Business Name | PRIME HEALTHCARE HOME CARE AND HOSPICE, LLC
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 555 W COURT ST STE 212
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City | KANKAKEE
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State | IL
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Zip | 60901-3674
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Country | US
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Telephone | 815-937-2475
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Fax |
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Provider Business Mailing Address
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Address Line | 555 W COURT ST STE 212
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City | KANKAKEE
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State | IL
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Zip | 60901-3674
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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 | MANAGING ASSOCIATE GENERAL COUNSEL
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Name | CHRISTOPHER DOAN
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Credential |
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Telephone | 310-259-4706
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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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