Organization
HOME HEALTH AGENCY ILLINOIS, LLC
Active
Other names
Omni Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE RICO (MANAGER)
(305) 476-5160
Entity
Organization
Contact information
Practice address
19146 88TH AVE, MOKENA, IL 60448-8135
(708) 532-4466
(708) 532-4477
Mailing address
510 HOSPITAL DR, SUITE 100, MADISON, TN 37115-5033
(615) 712-2250
(615) 577-0081
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1010196
IL
Other
Enumeration date
09/15/2005
Last updated
07/10/2012
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