Provider Demographics
NPI:1013929124
Name:CARE FOR LIFE HOME HEALTH INC.
Entity Type:Organization
Organization Name:CARE FOR LIFE HOME HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PACHECO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:847-624-2594
Mailing Address - Street 1:2250 POINT BLVD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-7871
Mailing Address - Country:US
Mailing Address - Phone:847-214-3633
Mailing Address - Fax:847-214-3634
Practice Address - Street 1:2250 POINT BLVD
Practice Address - Street 2:SUITE 115
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-7871
Practice Address - Country:US
Practice Address - Phone:847-214-3633
Practice Address - Fax:847-214-3634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010550251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147933Medicare Oscar/Certification
IL147933Medicare ID - Type UnspecifiedPROVIDER NUMBER