Provider Demographics
NPI:1083152045
Name:GLORY HOME MAKER HOME HEALTH SERVICES INC
Entity Type:Organization
Organization Name:GLORY HOME MAKER HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKEEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-743-7831
Mailing Address - Street 1:18236 RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-3024
Mailing Address - Country:US
Mailing Address - Phone:708-743-7831
Mailing Address - Fax:
Practice Address - Street 1:18236 RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-3024
Practice Address - Country:US
Practice Address - Phone:708-743-7831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health