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General NPI Number Information
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NPI Number | 1952725038
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Entity Type | Organization
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Legal Business Name | 1ST ASSURE HOME HEALTH, LLC
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Dates
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Enumeration Date | 02/11/2014
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Last Update Date | 02/11/2014
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Provider Practice Location Address
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Address Line | 4343 OLD GRAND AVE SUITE 106
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City | GURNEE
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State | IL
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Zip | 60031-2767
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Country | US
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Telephone | 224-206-7459
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Fax |
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Provider Business Mailing Address
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Address Line | 850 W WINCHESTER RD
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-1333
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Country | US
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Telephone | 224-206-7459
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | FENG XIAO
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Credential |
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Telephone | 224-730-1167
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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 |
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License Number State |
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