Provider Demographics
NPI:1154585040
Name:HOME BOUND HEALTHCARE, INC.
Entity type:Organization
Organization Name:HOME BOUND HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:217-753-2260
Mailing Address - Street 1:421 SOUTH GRAND AVE W
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-3781
Mailing Address - Country:US
Mailing Address - Phone:217-753-2260
Mailing Address - Fax:217-753-2270
Practice Address - Street 1:421 S GRAND AVE W
Practice Address - Street 2:SUITE 2B
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-3781
Practice Address - Country:US
Practice Address - Phone:217-753-2260
Practice Address - Fax:217-753-2270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health