Providence At Home

LBN: Rest Haven Illiana Christian Convalescent Home
Providence At Home 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 / Home Health, which is considered as the primary health care specialty. Rest Haven Illiana Christian Convalescent Home can be contacted via phone (708) 331-2005, or through Zandstra, Johanna via phone (708) 342-8100.

Contact Information

Primary practice address
18601 N Creek Dr Tinley Park IL 60477-6397
Phone: (708) 331-2005
Fax: (708) 877-4818
Website:
Map and Directions
Authorized official contact:
Name: Zandstra, Johanna
Phone: (708) 342-8100

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X 1010138 Illinois

Profile Details

NPI number 1568461820
LBN Legal business name Rest Haven Illiana Christian Convalescent Home
DBA Doing business as Providence At Home
Authorized official Zandstra, Johanna
Entity Organization
Organization subpart 1 No
Enumeration date Jul 19th, 2005
Last updated Mar 28th, 2019 - about 5 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 1568461820 NPPES
Other 147559 MEDICARE
Other 50070 MEDICARE
Other 1010138 MEDICARE

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