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General NPI Number Information
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NPI Number | 1912690959
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Entity Type | Organization
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Legal Business Name | ELEVATED CARE AT HOME LLC
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Dates
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Enumeration Date | 05/26/2023
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 260 S SCHMIDT RD STE H3
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City | BOLINGBROOK
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State | IL
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Zip | 60440-3087
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Country | US
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Telephone | 630-728-4582
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Fax |
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Provider Business Mailing Address
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Address Line | 1736 BAYBROOK LN
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City | NAPERVILLE
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State | IL
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Zip | 60564-6173
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Country | US
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Telephone | 630-728-4582
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | SUNIL AGARWAL
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Credential |
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Telephone | 630-728-4582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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