Provider Demographics
NPI:1316644552
Name:VENTRACARE HOMES INC
Entity type:Organization
Organization Name:VENTRACARE HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:NWAFOR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:708-953-1476
Mailing Address - Street 1:1440 ASTER LN
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60490-4532
Mailing Address - Country:US
Mailing Address - Phone:708-953-1476
Mailing Address - Fax:800-990-3770
Practice Address - Street 1:11025 RIDGELAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60415-2492
Practice Address - Country:US
Practice Address - Phone:708-953-1476
Practice Address - Fax:800-990-3770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-08
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric