Provider Demographics
NPI:1013121532
Name:NORTHWEST HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:NORTHWEST HOME HEALTH CARE, INC.
Other - Org Name:NA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARO JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:219-397-8610
Mailing Address - Street 1:529 W CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:EAST CHICAGO
Mailing Address - State:IN
Mailing Address - Zip Code:46312-3206
Mailing Address - Country:US
Mailing Address - Phone:219-397-8610
Mailing Address - Fax:219-397-8611
Practice Address - Street 1:529 W CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-3206
Practice Address - Country:US
Practice Address - Phone:219-397-8610
Practice Address - Fax:219-397-8611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health