Provider Demographics
NPI:1669743100
Name:CARE AT HOME
Entity type:Organization
Organization Name:CARE AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:773-209-7316
Mailing Address - Street 1:7115 S SAWYER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-3535
Mailing Address - Country:US
Mailing Address - Phone:773-980-3268
Mailing Address - Fax:773-778-5433
Practice Address - Street 1:7115 S SAWYER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-3535
Practice Address - Country:US
Practice Address - Phone:773-980-3268
Practice Address - Fax:773-778-5433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2129082253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care