Provider Demographics
NPI:1578919379
Name:ILITCHI HOME CARE LLC
Entity Type:Organization
Organization Name:ILITCHI HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:I
Authorized Official - Last Name:ESPINOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-292-9511
Mailing Address - Street 1:1345 E MAIN ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-8961
Mailing Address - Country:US
Mailing Address - Phone:480-292-9511
Mailing Address - Fax:480-292-9411
Practice Address - Street 1:1345 E MAIN ST
Practice Address - Street 2:SUITE 111
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-8961
Practice Address - Country:US
Practice Address - Phone:480-292-9511
Practice Address - Fax:480-292-9411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health