Provider Demographics
NPI:1528402518
Name:ADDUS HEALTHCARE, INC.
Entity Type:Organization
Organization Name:ADDUS HEALTHCARE, INC.
Other - Org Name:ADDUS HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP, CHIEF STRATEGY OFFICER
Authorized Official - Prefix:MR
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:360-296-3400
Mailing Address - Fax:630-487-2713
Practice Address - Street 1:1311 FORT ST STE 0
Practice Address - Street 2:
Practice Address - City:BARLING
Practice Address - State:AR
Practice Address - Zip Code:72923-2045
Practice Address - Country:US
Practice Address - Phone:479-452-2652
Practice Address - Fax:479-452-2084
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADDUS HOMECARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-22
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4955251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR200410732 MAPCMedicaid
AR197330752Medicaid
AR197329797Medicaid
AR197325796Medicaid
AR197328757Medicaid