Provider Demographics
NPI:1932481397
Name:AMITY HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:AMITY HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SALVADOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SERRANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-286-8886
Mailing Address - Street 1:5901 N CICERO AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-5717
Mailing Address - Country:US
Mailing Address - Phone:773-286-8886
Mailing Address - Fax:773-283-9750
Practice Address - Street 1:5901 N CICERO AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-5717
Practice Address - Country:US
Practice Address - Phone:773-286-8886
Practice Address - Fax:773-283-9750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011417251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health