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NPI Code Detail

MEDICARE: THRIVING AT HOME HEALTH AGENCY

MEDICARE: THRIVING AT HOME HEALTH AGENCY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1295668127
Entity Type Code : Organization
Provider Name (Legal Business Name) : THRIVING AT HOME HEALTH AGENCY
Provider Business Mailing Address
First Line : 7610 N ROGERS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60626-1226
Country : US
Telephone Number : 773-629-5676
Fax Number :
Provider Business Practice Location Address
First Line : 7610 N ROGERS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60626-1226
Country : US
Telephone Number : 773-629-5676
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MUTUMBA MATANDA
Credential :
Telephone Number : 773-629-5676
Provider Enumeration Date : 06/08/2026
Last Update Date : 06/08/2026

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Directions to “THRIVING AT HOME HEALTH AGENCY ” Practice Location

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