Provider Demographics
NPI:1245457746
Name:HOME BOUND HEALTHCARE, INC.
Entity type:Organization
Organization Name:HOME BOUND HEALTHCARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:RINE
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:708-798-0800
Mailing Address - Street 1:17516 E CARRIAGEWAY DR
Mailing Address - Street 2:UNIT B
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2093
Mailing Address - Country:US
Mailing Address - Phone:708-798-0800
Mailing Address - Fax:708-798-0870
Practice Address - Street 1:17516 E CARRIAGEWAY DR
Practice Address - Street 2:UNIT B
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2093
Practice Address - Country:US
Practice Address - Phone:708-798-0800
Practice Address - Fax:708-798-0870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL5575760001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies