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General NPI Number Information
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NPI Number | 1972152601
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Entity Type | Organization
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Legal Business Name | HOMESTEAD HOME CARE AGENCY, L.L.C.
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 3605 WOODHEAD DR STE 105A ROOM#2
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City | NORTHBROOK
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State | IL
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Zip | 60062
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Country | US
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Telephone | 847-715-9191
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Fax | 847-919-4764
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Provider Business Mailing Address
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Address Line | 3605 WOODHEAD DR STE 105A ROOM#2
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City | NORTHBROOK
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State | IL
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Zip | 60062-1850
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Country | US
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Telephone | 847-715-9191
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Fax | 847-919-4764
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | HASSAN NKULABI
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Credential |
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Telephone | 847-715-9191
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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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