Provider Demographics
NPI:1780827840
Name:HEALING TO HEAL ANOTHER HOME HEALTHCARE, INC
Entity Type:Organization
Organization Name:HEALING TO HEAL ANOTHER HOME HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAZDAR
Authorized Official - Middle Name:K
Authorized Official - Last Name:MOHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-253-4750
Mailing Address - Street 1:1460 RENAISSANCE DR STE 403
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1349
Mailing Address - Country:US
Mailing Address - Phone:773-253-4750
Mailing Address - Fax:773-649-9217
Practice Address - Street 1:1460 RENAISSANCE DR STE 403
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1349
Practice Address - Country:US
Practice Address - Phone:773-253-4750
Practice Address - Fax:773-649-9217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-19
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011040251E00000X
IL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1011040OtherIDPH
IL148115Medicare UPIN