Provider Demographics
NPI:1255496295
Name:1ST HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:1ST HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:GARCIA
Authorized Official - Last Name:DELA CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:773-275-7935
Mailing Address - Street 1:5875 N LINCOLN AVE
Mailing Address - Street 2:SUITE 229
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-4672
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5875 N LINCOLN AVE
Practice Address - Street 2:SUITE 229
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-4672
Practice Address - Country:US
Practice Address - Phone:773-275-7935
Practice Address - Fax:773-275-7936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147870251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147870Medicare ID - Type UnspecifiedHOME HEALTH CARE