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Organization

IN HOME HEALTH LLC

Active
Other names
ProMedica Hospice (Fairview Heights), ProMedica Hospice (Springfield)
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARTIN D ALLEN (DIRECTOR)
(419) 252-5734
Entity
Organization

Contact information

Practice address
333 SALEM PL, SUITE 165, FAIRVIEW HEIGHTS, IL 62208-1341
(618) 632-0304
(618) 632-0364
Mailing address
333 N SUMMIT ST, DEAN SHIPMAN, TOLEDO, OH 43604-2615
(419) 254-7841
(419) 254-5494

Taxonomy

Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
251G00000X
Community Based Hospice Care Agency
Primary
2001311
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1700105152
MO
Enumeration date
05/25/2010
Last updated
04/15/2022
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