# HOSS B, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Broad Street Home Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992246425
- **Authorized official:** MR. SAMUEL CROSS (ADMINISTRATOR)
- **Authorized official phone:** (847) 728-0134

## Contact information

- **Practice address:** 1229 GREEN BAY RD, WILMETTE, IL 60091-1679
- **Practice address phone:** (847) 728-0134
- **Practice address fax:** (888) 263-1945
- **Mailing address:** 1229 GREEN BAY RD, WILMETTE, IL 60091-1679
- **Mailing address phone:** (847) 728-0134
- **Mailing address fax:** (888) 263-1945

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 3001291 | IL | Yes |

## Other

- **Enumeration date:** 03/16/2017
- **Last updated:** 03/20/2017