Provider Demographics
NPI:1710128418
Name:GOLD COAST HOME HEALTH, INC.
Entity Type:Organization
Organization Name:GOLD COAST HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:REUBEN
Authorized Official - Middle Name:CUDJOE
Authorized Official - Last Name:HADZIDE
Authorized Official - Suffix:
Authorized Official - Credentials:MR
Authorized Official - Phone:312-315-1934
Mailing Address - Street 1:5291 PROVIDENCE DR
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-1188
Mailing Address - Country:US
Mailing Address - Phone:312-315-1934
Mailing Address - Fax:312-229-0067
Practice Address - Street 1:20200 GOVERNORS DR STE 204
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1056
Practice Address - Country:US
Practice Address - Phone:773-488-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-10
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health