Organization
PRIVATE HOME CARE OF ILLINOIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAMILLE HAMMERS (CONTROLLER)
(618) 713-1268
Entity
Organization
Contact information
Practice address
111 E 4TH ST STE 110, ALTON, IL 62002-6206
(618) 558-5299
Mailing address
9338 OLIVE BLVD STE 200, SAINT LOUIS, MO 63132-3248
(618) 713-1268
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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