Provider Demographics
NPI:1952725038
Name:1ST ASSURE HOME HEALTH, LLC
Entity Type:Organization
Organization Name:1ST ASSURE HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FENG
Authorized Official - Middle Name:
Authorized Official - Last Name:XIAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-730-1167
Mailing Address - Street 1:850 W WINCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-1333
Mailing Address - Country:US
Mailing Address - Phone:224-206-7459
Mailing Address - Fax:
Practice Address - Street 1:4343 OLD GRAND AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-2767
Practice Address - Country:US
Practice Address - Phone:224-206-7459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health