Provider Demographics
NPI:1295967560
Name:FIRST VENTURE HOME HEALTHCARE, INC.
Entity type:Organization
Organization Name:FIRST VENTURE HOME HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:LINGAN
Authorized Official - Last Name:QUINTO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:847-506-9767
Mailing Address - Street 1:121 S. WILKE RD
Mailing Address - Street 2:SUITE 204-D
Mailing Address - City:ARUNGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-1533
Mailing Address - Country:US
Mailing Address - Phone:847-506-9767
Mailing Address - Fax:847-506-9769
Practice Address - Street 1:121 S. WILKE RD.
Practice Address - Street 2:SUITE 204-D
Practice Address - City:ARUNGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1533
Practice Address - Country:US
Practice Address - Phone:847-506-9767
Practice Address - Fax:847-506-9769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-19
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011050251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health