# GERIACARE HOME HEALTHCARE INC

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

## Provider details

- **NPI number:** 1982886974
- **Authorized official:** MR. ROY BONGON SIAPNO BSN RN (ADMINISTRATOR/AGENCY SUPERVISOR)
- **Authorized official phone:** (630) 620-9305

## Contact information

- **Practice address:** 450 E 22ND ST, SUITE 172, LOMBARD, IL 60148-6113
- **Practice address phone:** (630) 620-9305
- **Practice address fax:** (630) 216-1150
- **Mailing address:** 450 E 22ND ST, SUITE 172, LOMBARD, IL 60148-6113
- **Mailing address phone:** (630) 620-9305
- **Mailing address fax:** (630) 216-1150

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 1010750 | IL | Yes |

## Other

- **Enumeration date:** 11/30/2007
- **Last updated:** 02/15/2013