Provider Demographics
NPI:1174849350
Name:ABN CARE HOME HEALTH, LLC
Entity type:Organization
Organization Name:ABN CARE HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:PALACIOS
Authorized Official - Last Name:LAGUMBAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:773-812-6493
Mailing Address - Street 1:4751 S CENTRAL AVE
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-1557
Mailing Address - Country:US
Mailing Address - Phone:708-924-0433
Mailing Address - Fax:708-924-4045
Practice Address - Street 1:4751 S CENTRAL AVE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-1557
Practice Address - Country:US
Practice Address - Phone:708-924-0433
Practice Address - Fax:708-924-4045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011007251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health