Organization
LIFE CARE HOME HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICK W GRIFFIN (PRESIDENT)
(706) 303-5500
Entity
Organization
Contact information
Practice address
2255 MONARCH DR, NAPERVILLE, IL 60563-4164
(630) 300-1152
(630) 300-1154
Mailing address
PO BOX 200, AUGUSTA, GA 30903-0200
(706) 303-5500
(706) 854-7382
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1008374
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1008374
HHA LICENSE
IL
01
—
14D0922469
CLIA WAIVER
IL
Enumeration date
05/15/2007
Last updated
03/08/2016
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