Organization
HEAVENLYHOMES2008
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SMITH (OWNER)
(708) 527-8338
Entity
Organization
Contact information
Practice address
15917 DREXEL AVE, SOUTH HOLLAND, IL 60473-1637
(708) 527-8338
(708) 331-5654
Mailing address
15917 DREXEL AVE, SOUTH HOLLAND, IL 60473-1637
(708) 527-8338
(708) 331-5654
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
Primary
S53046573199
IL
Other
Enumeration date
06/05/2008
Last updated
06/05/2008
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