MEDICARE: A HOUSE CALLED BEAUTIFUL

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	174200000X	Meals Provider
2	177F00000X	Lodging Provider
3	251E00000X	Home Health Agency
4	253Z00000X	In Home Supportive Care Agency
5	310400000X	Assisted Living Facility
6	3104A0625X	Assisted Living Facility (Mental Illness)
7	3104A0630X	Assisted Living Facility (Behavioral Disturbances)
8	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1417691437
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A HOUSE CALLED BEAUTIFUL

Provider Business Mailing Address
First Line	:	1758 ARLINGTON LN
Second Line	:
City	:	GLENDALE HEIGHTS
State	:	IL
Zip	:	60139-1892
Country	:	US
Telephone Number	:	630-460-7028
Fax Number	:

Provider Business Practice Location Address
First Line	:	1758 ARLINGTON LN
Second Line	:
City	:	GLENDALE HEIGHTS
State	:	IL
Zip	:	60139-1892
Country	:	US
Telephone Number	:	630-460-7028
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KATHRINE ANN CLARK
Credential	:
Telephone Number	:	630-460-7028

Provider Enumeration Date	:	04/26/2022
Last Update Date	:	04/26/2022

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Directions to “A HOUSE CALLED BEAUTIFUL ” Practice Location

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