Organization
GRAND GONAIVES
Active
Other names
Prime Wellness Homecare Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. YVES BIENVENU JR. (MANAGER)
(773) 615-1638
Entity
Organization
Contact information
Practice address
2115 W 94TH ST, CHICAGO, IL 60643-6309
(773) 615-1638
Mailing address
2115 W 94TH ST, CHICAGO, IL 60643-6309
(773) 615-1638
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
342000000X
Transportation Network Company
—
—
Other
Enumeration date
01/13/2025
Last updated
02/12/2026
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