Provider Demographics
NPI:1316246713
Name:AHAVA HOME HEALTH, INC.
Entity type:Organization
Organization Name:AHAVA HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, RN
Authorized Official - Phone:708-758-1151
Mailing Address - Street 1:297 E GLENWOOD LANSING RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:GLENWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60425-1795
Mailing Address - Country:US
Mailing Address - Phone:708-758-1151
Mailing Address - Fax:
Practice Address - Street 1:297 E GLENWOOD LANSING RD
Practice Address - Street 2:SUITE 105
Practice Address - City:GLENWOOD
Practice Address - State:IL
Practice Address - Zip Code:60425-1795
Practice Address - Country:US
Practice Address - Phone:708-758-1151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health