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General NPI Number Information
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NPI Number | 1992145031
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Entity Type | Organization
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Legal Business Name | CHRIST MISSIONARY HOME HEALTH AGENCY, INC.
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Dates
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Enumeration Date | 07/03/2013
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 3121 W 71ST ST APT 2FRONT
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City | CHICAGO
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State | IL
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Zip | 60629-3003
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Country | US
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Telephone | 312-566-1888
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 368218
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City | CHICAGO
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State | IL
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Zip | 60636-8218
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Country | US
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Telephone | 312-566-1888
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Fax |
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Authorized Official
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Title or Position | MANAGER / DIRECTOR/ PRESIDENT/
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Name | PROF. MELLONY LASHON GANT
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Credential | HOME CARE SERVICES
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Telephone | 312-566-1888
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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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Taxonomy #2
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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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