Provider Demographics
NPI:1245894088
Name:LUCY'S HOME CARE EXPRESS, INC
Entity type:Organization
Organization Name:LUCY'S HOME CARE EXPRESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LUCILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:CSCM,CDP
Authorized Official - Phone:847-599-8181
Mailing Address - Street 1:2424 GRAND AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-3315
Mailing Address - Country:US
Mailing Address - Phone:847-599-8181
Mailing Address - Fax:847-672-8943
Practice Address - Street 1:2424 GRAND AVE
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-3315
Practice Address - Country:US
Practice Address - Phone:847-599-8181
Practice Address - Fax:847-672-8943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-26
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty