Organization
GRAND HOME HEALTH CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIA L. BUENDIA R.N. (ADMINISTRATOR / VICE PRESIDENT)
(773) 413-6750
Entity
Organization
Contact information
Practice address
7435 W BELMONT AVE, CHICAGO, IL 60634-3330
(773) 413-6750
(773) 413-6756
Mailing address
7435 W BELMONT AVE, CHICAGO, IL 60634-3330
(773) 413-6750
(773) 413-6756
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
IL1009794
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
217035
MEDICARE PART B
IL
01
—
5085
BLUE CROSS BLUE SHIELD
IL
Enumeration date
05/11/2006
Last updated
11/11/2008
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