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Organization

GERIACARE HOME HEALTHCARE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROY BONGON SIAPNO BSN RN (ADMINISTRATOR/AGENCY SUPERVISOR)
(630) 620-9305
Entity
Organization

Contact information

Practice address
450 E 22ND ST, SUITE 172, LOMBARD, IL 60148-6113
(630) 620-9305
(630) 216-1150
Mailing address
450 E 22ND ST, SUITE 172, LOMBARD, IL 60148-6113
(630) 620-9305
(630) 216-1150

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1010750
IL

Other

Enumeration date
11/30/2007
Last updated
02/15/2013
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