Provider Demographics
NPI:1013151752
Name:GOODHEALTH HOME CARE, INC.
Entity Type:Organization
Organization Name:GOODHEALTH HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NELLIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:773-933-6020
Mailing Address - Street 1:9644 S COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-5021
Mailing Address - Country:US
Mailing Address - Phone:773-933-6020
Mailing Address - Fax:773-933-6025
Practice Address - Street 1:9644 S COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-5021
Practice Address - Country:US
Practice Address - Phone:773-933-6020
Practice Address - Fax:773-933-6025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-24
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health