Provider Demographics
NPI:1093041360
Name:BEVERLY HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:BEVERLY HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSITA
Authorized Official - Middle Name:CUYUGAN
Authorized Official - Last Name:TRI NIDAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-583-1626
Mailing Address - Street 1:2045 S. ARLINGTON HEIGHTS ROAD
Mailing Address - Street 2:STE 116
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-1499
Mailing Address - Country:US
Mailing Address - Phone:708-583-1626
Mailing Address - Fax:708-221-7196
Practice Address - Street 1:2045 S. ARLINGTON HEIGHTS ROAD,
Practice Address - Street 2:1STE 116
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1499
Practice Address - Country:US
Practice Address - Phone:708-583-1626
Practice Address - Fax:708-221-7196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-21
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health