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General NPI Number Information
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NPI Number | 1851562300
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Entity Type | Organization
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Legal Business Name | MAHONEY HOME HEALTHCARE SERVICES INC.
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Dates
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Enumeration Date | 03/12/2008
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 9133 S STONY ISLAND AVE SUITE 2
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City | CHICAGO
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State | IL
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Zip | 60617-3512
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Country | US
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Telephone | 773-375-9300
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Fax | 773-375-9337
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Provider Business Mailing Address
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Address Line | 9133 S STONY ISLAND AVE SUITE 2
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City | CHICAGO
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State | IL
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Zip | 60617-3512
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Country | US
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Telephone | 773-375-9300
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Fax | 773-375-9337
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | JOHNNY LEE CARTER JR.
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Credential |
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Telephone | 773-375-9300
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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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