Provider Demographics
NPI:1225277171
Name:HOMELINK HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:HOMELINK HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ZOSIMO
Authorized Official - Middle Name:
Authorized Official - Last Name:LABACO
Authorized Official - Suffix:JR
Authorized Official - Credentials:RN
Authorized Official - Phone:773-427-7588
Mailing Address - Street 1:5241 N ELSTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-1642
Mailing Address - Country:US
Mailing Address - Phone:773-427-7588
Mailing Address - Fax:
Practice Address - Street 1:5241 N ELSTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-1642
Practice Address - Country:US
Practice Address - Phone:773-427-7588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1910349251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1910349OtherSTATE LICENSE,PERMIT, CERTIFICATION, REGISTRATION