Organization
DOVE MANDELA
Active
Other names
Dove Mandela Home Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MALCOLM MANDELA LEE SR. (OWNER/DIRECTOR)
(708) 200-4979
Entity
Organization
Contact information
Practice address
22232 ROCKINGHAM RD, RICHTON PARK, IL 60471-1119
(708) 200-4979
Mailing address
22232 ROCKINGHAM RD, RICHTON PARK, IL 60471-1119
(708) 200-4979
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801344742
NPPES
IL
Enumeration date
02/18/2016
Last updated
09/23/2016
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