Organization
HOME BOUND HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEN PALIWODA LNHA (ADMINISTRATOR)
(815) 895-9898
Entity
Organization
Contact information
Practice address
1740 MEDITERRANEAN DR STE 101, SYCAMORE, IL 60178-3143
(815) 895-9898
(815) 985-3232
Mailing address
1740 MEDITERRANEAN DR STE 101, SYCAMORE, IL 60178-3143
(815) 895-9898
(815) 985-3232
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1010949
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14D1091029
CLIA CERTIFICATE WAIVER
IL
Enumeration date
10/21/2008
Last updated
11/28/2008
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