Organization
AT HOME HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK CUSTARDO J.D. (CREDENTIALLING OFFICER)
(630) 362-4469
Entity
Organization
Contact information
Practice address
9435 BORMET DR, UNIT 1, MOKENA, IL 60448-8363
(708) 478-6565
(708) 478-5458
Mailing address
9435 BORMET DR, UNIT 1, MOKENA, IL 60448-8363
(708) 478-6565
(708) 478-5458
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
APPLIED FOR
IL
Other
Enumeration date
03/29/2012
Last updated
03/29/2012
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