Provider Demographics
NPI:1548040058
Name:FOREVER HOME CARE SERVICE LLC
Entity type:Organization
Organization Name:FOREVER HOME CARE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-269-9726
Mailing Address - Street 1:4801 SOUTHWICK DR STE 630-C
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-2254
Mailing Address - Country:US
Mailing Address - Phone:708-269-9726
Mailing Address - Fax:
Practice Address - Street 1:4801 SOUTHWICK DR STE 630-C
Practice Address - Street 2:
Practice Address - City:MATTESON
Practice Address - State:IL
Practice Address - Zip Code:60443-2254
Practice Address - Country:US
Practice Address - Phone:708-269-9726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care