Organization
HOME BOUND HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIETA MITRA JR. (PRESIDENT/SECRETARY/TREASURER)
(708) 798-0800
Entity
Organization
Contact information
Practice address
14216 MCCARTHY RD UNIT A, LEMONT, IL 60439-9393
(708) 798-0800
(708) 798-0870
Mailing address
14216 MCCARTHY RD UNIT A, LEMONT, IL 60439-9393
(708) 798-0800
(708) 798-0870
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
1010413
IL
251E00000X
Home Health Agency
Primary
1011897
IL
291U00000X
Clinical Medical Laboratory
14D1036623
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1010413
HOME HEALTH AGENCY LIC
IL
01
—
14D1036623
CLIA CERT OF WAIVER
—
Enumeration date
01/30/2006
Last updated
02/01/2017
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