Provider Demographics
NPI:1114943750
Name:ADDUS HEALTHCARE INC
Entity Type:Organization
Organization Name:ADDUS HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP, CHIEF STRATEGY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DARBY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-296-3443
Mailing Address - Street 1:2300 WARRENVILLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1717
Mailing Address - Country:US
Mailing Address - Phone:630-296-3400
Mailing Address - Fax:
Practice Address - Street 1:823 W MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:SUMNER
Practice Address - State:WA
Practice Address - Zip Code:98390-1151
Practice Address - Country:US
Practice Address - Phone:253-863-1834
Practice Address - Fax:253-863-1663
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADDUS HOMECARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-15
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA187837Medicaid