# HOMECARE AND HAIR LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295465060
- **Authorized official:** CLESHAWN HENRY CMAA (MEDICAL ASSISTANT)
- **Authorized official phone:** (312) 777-9105

## Contact information

- **Practice address:** 3432 W DIVERSEY AVE FL 2, CHICAGO, IL 60647-1221
- **Practice address phone:** (312) 777-9105
- **Mailing address:** PO BOX 607004, CHICAGO, IL 60660-0961
- **Mailing address phone:** (773) 640-7474

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WH0200X | Home Health Registered Nurse | — | NULL | Yes |
| 163WH0200X | Home Health Registered Nurse | — | — | Yes |

## Other

- **Enumeration date:** 06/14/2022
- **Last updated:** 06/14/2022