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General NPI Number Information
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NPI Number | 1881143980
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Entity Type | Organization
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Legal Business Name | CHRIST MISSIONARY HOME HEALTH AGENCY,INC.
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Dates
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Enumeration Date | 09/29/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3121 W 71ST ST 5731 S. WASHTENAW
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City | CHICAGO
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State | IL
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Zip | 60629-3003
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Country | US
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Telephone | 312-566-1888
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Fax |
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Provider Business Mailing Address
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Address Line | 6120 S KEDZIE AVE 5731 S. WASHTENAW
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City | CHICAGO
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State | IL
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Zip | 60629-3319
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Country | US
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Telephone | 312-566-1888
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS MELLONY L GANT
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Credential |
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Telephone | 312-566-1888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | IL
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