Provider Demographics
NPI:1952862617
Name:ISR ENTERPRISES, INC.
Entity Type:Organization
Organization Name:ISR ENTERPRISES, INC.
Other - Org Name:SENIOR HELPERS OF ROCKFORD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER/AGENCY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:HUBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-395-8790
Mailing Address - Street 1:129 PHELPS AVE, BLDG 10, STE 1008
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108
Mailing Address - Country:US
Mailing Address - Phone:815-395-8790
Mailing Address - Fax:815-395-8790
Practice Address - Street 1:129 PHELPS AVE, BLDG 10, STE 1008
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108
Practice Address - Country:US
Practice Address - Phone:815-395-8790
Practice Address - Fax:815-395-8790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-26
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL3000153OtherILLINOIS DEPARTMENT OF PUBLIC HEALTH I.D. NUMBER