1598257693 NPI number — FOR PAPA'S SAKE HOME CARE FOR FAMILIES, LLC

Table of content: (NPI 1598257693)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598257693 NPI number — FOR PAPA'S SAKE HOME CARE FOR FAMILIES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOR PAPA'S SAKE HOME CARE FOR FAMILIES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
INDEPENDENCE-4-SENIORS
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598257693
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/09/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
34 S DUNTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON HEIGHTS
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60005-1402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-973-0234
Provider Business Mailing Address Fax Number:
847-873-0227

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
34 S DUNTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLINGTON HEIGHTS
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60005-1402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-973-0234
Provider Business Practice Location Address Fax Number:
847-873-0227
Provider Enumeration Date:
06/04/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LENTZ
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
910-728-4668

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X , with the licence number: 3000659 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)