Provider Demographics
NPI:1770086175
Name:GRISWOLD HOME CARE
Entity type:Organization
Organization Name:GRISWOLD HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HOME CARE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-961-6550
Mailing Address - Street 1:707 A DAVIS ROAD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123
Mailing Address - Country:US
Mailing Address - Phone:847-961-6550
Mailing Address - Fax:847-961-6560
Practice Address - Street 1:707 A DAVIS ROAD
Practice Address - Street 2:SUITE 203
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123
Practice Address - Country:US
Practice Address - Phone:847-961-6550
Practice Address - Fax:847-961-6560
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRISWOLD INTERNATIONAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3001474372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty