Provider Demographics
NPI:1336117621
Name:AMBERCARE HOME HEALTH CARE CORPORATION
Entity Type:Organization
Organization Name:AMBERCARE HOME HEALTH CARE CORPORATION
Other - Org Name:AMBERCARE HOME HEALTH
Other - Org Type:Doing Business As
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:630-487-2713
Practice Address - Street 1:2129 OSUNA RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-1002
Practice Address - Country:US
Practice Address - Phone:505-244-0046
Practice Address - Fax:505-217-0429
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMBERCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-10
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6392251E00000X, 251E00000X
253Z00000X, 3747P1801X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMN2415Medicaid
327123Medicare ID - Type Unspecified