Provider Demographics
NPI:1437370574
Name:REGENCY HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:REGENCY HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ODAFE
Authorized Official - Middle Name:
Authorized Official - Last Name:ONOMAKPOME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-397-1614
Mailing Address - Street 1:3847 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:EAST CHICAGO
Mailing Address - State:IN
Mailing Address - Zip Code:46312-2332
Mailing Address - Country:US
Mailing Address - Phone:219-397-1614
Mailing Address - Fax:219-397-1634
Practice Address - Street 1:3847 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-2332
Practice Address - Country:US
Practice Address - Phone:219-397-1614
Practice Address - Fax:219-397-1634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health