Provider Demographics
NPI:1477652998
Name:CAREFIRST HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:CAREFIRST HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DON
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DOLORES
Authorized Official - Last Name:ENGRACIA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:847-677-9662
Mailing Address - Street 1:6731 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-3606
Mailing Address - Country:US
Mailing Address - Phone:847-677-9662
Mailing Address - Fax:847-677-9661
Practice Address - Street 1:7101 N CICERO AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-2112
Practice Address - Country:US
Practice Address - Phone:847-677-9662
Practice Address - Fax:847-677-9661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010500251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147858Medicare ID - Type UnspecifiedHOME HEALTH AGENCY