Provider Demographics
NPI:1063758068
Name:NEW AGE HOME HEALTH
Entity type:Organization
Organization Name:NEW AGE HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANINA
Authorized Official - Suffix:
Authorized Official - Credentials:SW
Authorized Official - Phone:847-791-1215
Mailing Address - Street 1:3601 W. DEVON AVE
Mailing Address - Street 2:# 108
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659
Mailing Address - Country:US
Mailing Address - Phone:847-403-3053
Mailing Address - Fax:
Practice Address - Street 1:3601 W. DEVON AVE
Practice Address - Street 2:# 108
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659
Practice Address - Country:US
Practice Address - Phone:847-403-3053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health