Provider Demographics
NPI:1821442310
Name:HOSPITALITY BUILDING SERVICES
Entity Type:Organization
Organization Name:HOSPITALITY BUILDING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROSEVELT
Authorized Official - Middle Name:C
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:847-731-6516
Mailing Address - Street 1:4219 GREGORY DR
Mailing Address - Street 2:
Mailing Address - City:ZION
Mailing Address - State:IL
Mailing Address - Zip Code:60099-1345
Mailing Address - Country:US
Mailing Address - Phone:847-731-6516
Mailing Address - Fax:
Practice Address - Street 1:4219 GREGORY DR
Practice Address - Street 2:
Practice Address - City:ZION
Practice Address - State:IL
Practice Address - Zip Code:60099-1345
Practice Address - Country:US
Practice Address - Phone:847-731-6516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILHS362406-8617343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)