Provider Demographics
NPI:1871863365
Name:HOZZY'S HOME HEALTH
Entity Type:Organization
Organization Name:HOZZY'S HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAYE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOSBROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:309-360-3181
Mailing Address - Street 1:222 S HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:METAMORA
Mailing Address - State:IL
Mailing Address - Zip Code:61548-9779
Mailing Address - Country:US
Mailing Address - Phone:309-360-3181
Mailing Address - Fax:
Practice Address - Street 1:222 S HANOVER ST
Practice Address - Street 2:
Practice Address - City:METAMORA
Practice Address - State:IL
Practice Address - Zip Code:61548-9779
Practice Address - Country:US
Practice Address - Phone:309-360-3181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty