Provider Demographics
NPI:1609128271
Name:ADDUS HEALTHCARE (DELAWARE), INC
Entity Type:Organization
Organization Name:ADDUS HEALTHCARE (DELAWARE), INC
Other - Org Name:ADDUS HOME CARE DELAWARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP CGRO
Authorized Official - Prefix:MS
Authorized Official - First Name:DARBY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-296-3400
Mailing Address - Street 1:2300 WARRENVILLE RD
Mailing Address - Street 2:SUITE 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 1:1675 S STATE ST
Practice Address - Street 2:ROOM A
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-5140
Practice Address - Country:US
Practice Address - Phone:302-222-7087
Practice Address - Fax:302-424-4974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-08
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE251C00000X, 251F00000X, 253J00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251F00000XAgenciesHome Infusion
No253J00000XAgenciesFoster Care Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE761414Medicaid
DE519055OtherMEDICARE ID - TYPE UNSPECIFIED
DE761414Medicaid