- Enrollment id
- O20090910000105
- Enrollment state
- IL
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1336377365
- Multiple npi flag
- N
- Ccn
- 147568
- Associate id
- 4789739038
- Organization name
- RESIDENTIAL HOME HEALTH ILLINOIS, LLC
- Doing business as name
- RESIDENTIAL HOME HEALTH
- Incorporation date
- 2009-05-11
- Incorporation state
- IL
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 2443 WARRENVILLE RD
- Address line 2
- STE 500
- City
- LISLE
- State
- IL
- Zip code
- 605324356