Provider Demographics
NPI:1851562300
Name:MAHONEY HOME HEALTHCARE SERVICES INC.
Entity Type:Organization
Organization Name:MAHONEY HOME HEALTHCARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:773-375-9300
Mailing Address - Street 1:9133 S STONY ISLAND AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-3512
Mailing Address - Country:US
Mailing Address - Phone:773-375-9300
Mailing Address - Fax:773-375-9337
Practice Address - Street 1:9133 S STONY ISLAND AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-3512
Practice Address - Country:US
Practice Address - Phone:773-375-9300
Practice Address - Fax:773-375-9337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health