Provider Demographics
NPI:1609039833
Name:AMBERCARE HOME HEALTH CARE CORPORATION
Entity Type:Organization
Organization Name:AMBERCARE HOME HEALTH CARE CORPORATION
Other - Org Name:AMBERCARE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP, CHIEF STRATEGY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DARBY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-296-3591
Mailing Address - Street 1:2300 WARRENVILLE RD.
Mailing Address - Street 2:STE 100
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1765
Mailing Address - Country:US
Mailing Address - Phone:630-296-3400
Mailing Address - Fax:630-487-2713
Practice Address - Street 1:3870 FOOTHILLS RD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4631
Practice Address - Country:US
Practice Address - Phone:575-652-5766
Practice Address - Fax:575-556-0460
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMBERCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-08
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6537251E00000X
NM6537B1251E00000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMN2836Medicaid
NMN2836Medicaid