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General NPI Number Information
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NPI Number | 1962642033
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Entity Type | Organization
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Legal Business Name | CIRCLE OF FRIENDS HOME HEALTH CARE,LLC
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Dates
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Enumeration Date | 03/02/2009
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Last Update Date | 03/02/2009
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Provider Practice Location Address
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Address Line | 7848 W ODGEN AVE
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City | LYONS
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State | IL
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Zip | 60534-1389
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Country | US
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Telephone | 708-442-4962
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Fax | 708-442-4962
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Provider Business Mailing Address
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Address Line | 7848 W. OGDEN AVE-B EAST
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City | LYONS
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State | IL
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Zip | 60534-1389
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Country | US
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Telephone | 708-442-4962
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Fax | 708-442-4962
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. SUDHIR KUMAR
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Credential | OTR/L
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Telephone | 708-442-4962
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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 | APPLIED FOR
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License Number State | IL
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