Provider Demographics
NPI:1609018332
Name:NEW CREATION HOME CARE SERVICES,INC
Entity Type:Organization
Organization Name:NEW CREATION HOME CARE SERVICES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:EUNICE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CORDERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-530-5170
Mailing Address - Street 1:297 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-1210
Mailing Address - Country:US
Mailing Address - Phone:630-530-5170
Mailing Address - Fax:630-941-8227
Practice Address - Street 1:297 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181-1210
Practice Address - Country:US
Practice Address - Phone:630-530-5170
Practice Address - Fax:630-941-8227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care