Provider Demographics
NPI:1972152601
Name:HOMESTEAD HOME CARE AGENCY, L.L.C.
Entity Type:Organization
Organization Name:HOMESTEAD HOME CARE AGENCY, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NKULABI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-715-9191
Mailing Address - Street 1:3605 WOODHEAD DR
Mailing Address - Street 2:STE 105A ROOM#2
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1850
Mailing Address - Country:US
Mailing Address - Phone:847-715-9191
Mailing Address - Fax:847-919-4764
Practice Address - Street 1:3605 WOODHEAD DR
Practice Address - Street 2:STE 105A ROOM#2
Practice Address - City:NORTHBROOK,
Practice Address - State:IL
Practice Address - Zip Code:60062
Practice Address - Country:US
Practice Address - Phone:847-715-9191
Practice Address - Fax:847-919-4764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-05
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care