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Organization

GBS MEMORIAL HOME HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. HILDA S SOYODE RN (ADMINISTRATOR)
(708) 429-0414
Entity
Organization

Contact information

Practice address
6732 173RD ST STE 5, TINLEY PARK, IL 60477-3480
(708) 429-0414
(708) 429-0670
Mailing address
6732 173RD ST STE 5, TINLEY PARK, IL 60477-3480
(708) 429-0414
(708) 429-0670

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
IL1010596
IL
251F00000X
Home Infusion Agency
IL1010596
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
IL1010596
ILLINOIS STATE LICENSE
IL
Enumeration date
09/27/2006
Last updated
11/09/2016
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