Organization
PRN PROFESSIONALS HOME SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDY ROGERS COTA/L (OWNER)
(618) 895-8317
Entity
Organization
Contact information
Practice address
305 MAIN ST, MOUNT VERNON, IL 62864-3647
(618) 895-8317
Mailing address
305 MAIN ST, MOUNT VERNON, IL 62864-3647
(618) 895-8317
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
—
—
385HR2050X
Respite Care Camp
—
—
Other
Enumeration date
02/20/2025
Last updated
11/04/2025
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