Providence Hospice

LBN: Rest Haven Illiana Christian Convalescent Home
Providence Hospice is an health care organization with primary practice located at 18601 N Creek Dr , Tinley Park IL 60477-6397. The organization recently has only one registered license in Agencies / Hospice Care, Community Based, which is considered as the primary health care specialty. Rest Haven Illiana Christian Convalescent Home can be contacted via phone (708) 331-0400, or through Vandergenugten, Barry via phone (708) 342-8141.

Contact Information

Primary practice address
18601 N Creek Dr Tinley Park IL 60477-6397
Phone: (708) 331-0400
Fax: (708) 877-4818
Website:
Map and Directions
Authorized official contact:
Name: Vandergenugten, Barry
Phone: (708) 342-8141

Health care specialties

SpecialtyCodeLicense #State
Agencies / Hospice Care, Community Based 251G00000X 2002251 Illinois

Profile Details

NPI number 1407855562
LBN Legal business name Rest Haven Illiana Christian Convalescent Home
DBA Doing business as Providence Hospice
Authorized official Vandergenugten, Barry
Entity Organization
Organization subpart 1 No
Enumeration date Jul 20th, 2005
Last updated Apr 2nd, 2019 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407855562 NPPES
Illinois Other 2002251 HOSPICE LICENSE NUMBER

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