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General NPI Number Information
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NPI Number | 1871518779
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Entity Type | Organization
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Legal Business Name | HOME HEALTH RESOURCE, LLC
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 02/04/2009
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Provider Practice Location Address
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Address Line | 2295 VALLEY CREEK DR
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City | ELGIN
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State | IL
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Zip | 60123-2694
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Country | US
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Telephone | 847-608-9905
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Fax | 847-608-9915
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Provider Business Mailing Address
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Address Line | 2295 VALLEY CREEK DR
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City | ELGIN
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State | IL
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Zip | 60123-2694
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Country | US
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Telephone | 847-608-9905
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Fax | 847-608-9915
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | MISS JACQUELINE PONCE DE LEON
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Credential | RN
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Telephone | 847-608-9905
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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 | 1010457
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License Number State | IL
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