Provider Demographics
NPI:1184635567
Name:HOME BOUND HEALTHCARE, INC.
Entity Type:Organization
Organization Name:HOME BOUND HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-762-7900
Mailing Address - Street 1:3401 16TH ST
Mailing Address - Street 2:SUITE #5
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-6046
Mailing Address - Country:US
Mailing Address - Phone:309-762-7900
Mailing Address - Fax:309-762-6909
Practice Address - Street 1:3401 16TH ST
Practice Address - Street 2:SUITE #5
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-6046
Practice Address - Country:US
Practice Address - Phone:309-762-7900
Practice Address - Fax:309-762-6909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010622251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========003Medicaid
IL=========003Medicaid