Provider Demographics
NPI:1013255900
Name:HAVE A HEART HOMEMAKER SERVICES, LTD
Entity type:Organization
Organization Name:HAVE A HEART HOMEMAKER SERVICES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROCKINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:AA
Authorized Official - Phone:708-756-2500
Mailing Address - Street 1:1523 OTTO BLVD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60411-3442
Mailing Address - Country:US
Mailing Address - Phone:708-756-2500
Mailing Address - Fax:708-756-2501
Practice Address - Street 1:1523 OTTO BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60411-3442
Practice Address - Country:US
Practice Address - Phone:708-756-2500
Practice Address - Fax:708-756-2501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care