Provider Demographics
NPI:1598257693
Name:FOR PAPA'S SAKE HOME CARE FOR FAMILIES, LLC
Entity Type:Organization
Organization Name:FOR PAPA'S SAKE HOME CARE FOR FAMILIES, LLC
Other - Org Name:INDEPENDENCE-4-SENIORS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-728-4668
Mailing Address - Street 1:34 S DUNTON AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-1402
Mailing Address - Country:US
Mailing Address - Phone:847-973-0234
Mailing Address - Fax:847-873-0227
Practice Address - Street 1:34 S DUNTON AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1402
Practice Address - Country:US
Practice Address - Phone:847-973-0234
Practice Address - Fax:847-873-0227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-04
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163W00000X, 251E00000X
IL3000659253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No251E00000XAgenciesHome Health