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General NPI Number Information
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NPI Number | 1871863365
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Entity Type | Organization
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Legal Business Name | HOZZY'S HOME HEALTH
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Dates
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Enumeration Date | 12/30/2011
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Last Update Date | 12/30/2011
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Provider Practice Location Address
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Address Line | 222 S HANOVER ST
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City | METAMORA
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State | IL
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Zip | 61548-9779
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Country | US
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Telephone | 309-360-3181
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Fax |
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Provider Business Mailing Address
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Address Line | 222 S HANOVER ST
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City | METAMORA
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State | IL
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Zip | 61548-9779
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Country | US
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Telephone | 309-360-3181
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. RAYE L HOSBROUGH
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Credential | CNA
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Telephone | 309-360-3181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State | IL
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