Provider Demographics
NPI:1396774287
Name:PRIORITY HOME HEALTH CARE, INC
Entity type:Organization
Organization Name:PRIORITY HOME HEALTH CARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EVP CHIEF STRATEGY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DARBY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-296-3400
Mailing Address - Street 1:2300 WARRENVILLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1717
Mailing Address - Country:US
Mailing Address - Phone:630-296-3591
Mailing Address - Fax:
Practice Address - Street 1:291 N CLEVELAND MASSILLON RD STE 203
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-4513
Practice Address - Country:US
Practice Address - Phone:330-869-9520
Practice Address - Fax:330-869-9524
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADDUS HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-02
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0372609Medicaid
OH0849327OtherMEDICAID DISAB & MED FRAG
OH1801027OtherOHIO MRDD I-O WAIVER
OH497783OtherOH DEPT OF AGING
OH55-1818531OtherPDA WAIVER PROGRAM
OH1801027OtherOHIO MRDD I-O WAIVER