Provider Demographics
NPI:1700953023
Name:JUST GOOD CARE HOME HEALTH INC.
Entity Type:Organization
Organization Name:JUST GOOD CARE HOME HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:GERLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-974-2000
Mailing Address - Street 1:8130 W 111TH ST
Mailing Address - Street 2:
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465-2206
Mailing Address - Country:US
Mailing Address - Phone:708-974-2000
Mailing Address - Fax:708-974-2001
Practice Address - Street 1:8130 W 111TH ST
Practice Address - Street 2:
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-2206
Practice Address - Country:US
Practice Address - Phone:708-974-2000
Practice Address - Fax:708-974-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1747751251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14-7838Medicare ID - Type Unspecified