# DOVE MANDELA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dove Mandela Home Health Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801344742
- **Authorized official:** MR. MALCOLM MANDELA LEE I (HEALTH CARE ADMINISTRATOR)
- **Authorized official phone:** (708) 200-4979

## Contact information

- **Practice address:** 22232 ROCKINGHAM RD, RICHTON PARK, IL 60471-1119
- **Practice address phone:** (708) 200-4979
- **Mailing address:** 22232 ROCKINGHAM RD, RICHTON PARK, IL 60471-1119
- **Mailing address phone:** (708) 200-4979

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 09/20/2016
- **Last updated:** 09/20/2016