Provider Demographics
NPI:1336547488
Name:JOSHUA ALLIED HOME HEALTH CORPORATION NFP
Entity Type:Organization
Organization Name:JOSHUA ALLIED HOME HEALTH CORPORATION NFP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GERVASE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-458-7527
Mailing Address - Street 1:4250 N MARINE DR APT 2534
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-1741
Mailing Address - Country:US
Mailing Address - Phone:773-458-7527
Mailing Address - Fax:
Practice Address - Street 1:4250 N MARINE DR APT 2534
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-1741
Practice Address - Country:US
Practice Address - Phone:773-458-7527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health