Organization
SURE CARE HOME SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MYLENE MASICLAT (PRESIDENT)
(630) 295-9058
Entity
Organization
Contact information
Practice address
1155 N MAIN ST, SUITE C & D, GLENDALE HEIGHTS, IL 60139-3508
(630) 295-9058
(630) 295-9059
Mailing address
1155 N MAIN ST, SUITE C & D, GLENDALE HEIGHTS, IL 60139-3508
(630) 295-9058
(630) 295-9059
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
66258807
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
66258807
STATE OF ILLNOIS BUSINESS LICENSE
IL
01
—
PENDING/PROVISIONAL
ILLINOIS DEPARTMENT OF PUBLIC HEALTH LICENSE
IL
Enumeration date
01/14/2009
Last updated
01/14/2009
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