Provider Demographics
NPI:1821156316
Name:GAFFEY HOME NURSING & HOSPICE INC.
Entity Type:Organization
Organization Name:GAFFEY HOME NURSING & HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:GAFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN
Authorized Official - Phone:815-626-3467
Mailing Address - Street 1:3408 23RD STREET
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-9752
Mailing Address - Country:US
Mailing Address - Phone:815-626-3467
Mailing Address - Fax:815-626-8755
Practice Address - Street 1:3408 23RD STREET
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:IL
Practice Address - Zip Code:61081-9752
Practice Address - Country:US
Practice Address - Phone:815-626-3467
Practice Address - Fax:815-626-8755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1004845251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL147503Medicare ID - Type Unspecified