Organization
HOMECARE AND HAIR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLESHAWN HENRY CMAA (MEDICAL ASSISTANT)
(312) 777-9105
Entity
Organization
Contact information
Practice address
3432 W DIVERSEY AVE FL 2, CHICAGO, IL 60647-1221
(312) 777-9105
Mailing address
PO BOX 607004, CHICAGO, IL 60660-0961
(773) 640-7474
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
—
—
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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