Provider Demographics
NPI: | 1821498064 |
---|---|
Name: | PHC ACQUISITION CORPORATION |
Entity Type: | Organization |
Organization Name: | PHC ACQUISITION CORPORATION |
Other - Org Name: | ADDUS HOMECARE |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | EVP, CHIEF STRATEGY OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DARBY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ANDERSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 630-296-3443 |
Mailing Address - Street 1: | 2300 WARRENVILLE RD STE 100 |
Mailing Address - Street 2: | |
Mailing Address - City: | DOWNERS GROVE |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60515-1717 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 630-296-3400 |
Mailing Address - Fax: | 630-487-2713 |
Practice Address - Street 1: | 1255 TREAT BLVD # 362 |
Practice Address - Street 2: | |
Practice Address - City: | WALNUT CREEK |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94597-7968 |
Practice Address - Country: | US |
Practice Address - Phone: | 925-671-4110 |
Practice Address - Fax: | 877-477-5146 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | ADDUS HEALTHCARE, INC. |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2014-08-25 |
Last Update Date: | 2023-03-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 253Z00000X | Agencies | In Home Supportive Care |