Provider Demographics
NPI:1356007728
Name:PRIME HOME HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:PRIME HOME HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SOLOMON
Authorized Official - Middle Name:B
Authorized Official - Last Name:BADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-690-9087
Mailing Address - Street 1:7238 N BELL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-2004
Mailing Address - Country:US
Mailing Address - Phone:312-690-9087
Mailing Address - Fax:
Practice Address - Street 1:7238 N BELL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-2004
Practice Address - Country:US
Practice Address - Phone:312-690-9087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No251J00000XAgenciesNursing Care