Provider Demographics
NPI:1144461906
Name:ALPHONSA HOME HEALTH CARE,INC
Entity type:Organization
Organization Name:ALPHONSA HOME HEALTH CARE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AISHAMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-758-4077
Mailing Address - Street 1:743 N WILLOW RD
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-1766
Mailing Address - Country:US
Mailing Address - Phone:630-758-4077
Mailing Address - Fax:630-758-4078
Practice Address - Street 1:743 N WILLOW RD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-1766
Practice Address - Country:US
Practice Address - Phone:630-758-4077
Practice Address - Fax:630-758-4078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-08
Last Update Date:2009-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011063251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health