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Organization

DEZYEVE PRIORITY HOMECARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NKENG NGWEMOH (ADMINISTRATOR)
(331) 980-9016
Entity
Organization

Contact information

Practice address
2514 CALIENDO CIR, MONTGOMERY, IL 60538-4015
(331) 980-9016
Mailing address
2514 CALIENDO CIR, MONTGOMERY, IL 60538-4015
(331) 980-9016

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
01/31/2022
Last updated
01/31/2022
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