Provider Demographics
NPI:1043961642
Name:NURSES ON WHEELS HOMESERVICES LLC
Entity Type:Organization
Organization Name:NURSES ON WHEELS HOMESERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALESIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD CARLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-313-9040
Mailing Address - Street 1:11001 S MICHIGAN AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60628-4308
Mailing Address - Country:US
Mailing Address - Phone:773-313-9040
Mailing Address - Fax:
Practice Address - Street 1:11001 S MICHIGAN AVE STE 105
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60628-4308
Practice Address - Country:US
Practice Address - Phone:773-313-9040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-14
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health