Provider Demographics
NPI:1932309853
Name:AFFECTIONATE HOME HEALTH CARE,INC.
Entity Type:Organization
Organization Name:AFFECTIONATE HOME HEALTH CARE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ATILANA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-296-9544
Mailing Address - Street 1:17900 DIXIE HWY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-1754
Mailing Address - Country:US
Mailing Address - Phone:708-960-0093
Mailing Address - Fax:708-960-0467
Practice Address - Street 1:17900 DIXIE HWY
Practice Address - Street 2:SUITE 1
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1754
Practice Address - Country:US
Practice Address - Phone:708-960-0093
Practice Address - Fax:708-960-0467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010720251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health