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General NPI Number Information
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NPI Number | 1932309853
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Entity Type | Organization
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Legal Business Name | AFFECTIONATE HOME HEALTH CARE,INC.
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 17900 DIXIE HWY SUITE 1
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City | HOMEWOOD
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State | IL
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Zip | 60430-1754
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Country | US
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Telephone | 708-960-0093
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Fax | 708-960-0467
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Provider Business Mailing Address
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Address Line | 17900 DIXIE HWY SUITE 1
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City | HOMEWOOD
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State | IL
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Zip | 60430-1754
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Country | US
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Telephone | 708-960-0093
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Fax | 708-960-0467
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. ATILANA RIVERA
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Credential |
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Telephone | 708-296-9544
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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 | 1010720
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License Number State | IL
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