Provider Demographics
NPI:1699784439
Name:APHS
Entity type:Organization
Organization Name:APHS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:LORINE
Authorized Official - Last Name:TALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-731-1455
Mailing Address - Street 1:122 E 140CT.
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:LA
Mailing Address - Zip Code:60652
Mailing Address - Country:US
Mailing Address - Phone:312-731-1455
Mailing Address - Fax:773-924-8450
Practice Address - Street 1:122 E 140CT.
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:LA
Practice Address - Zip Code:60652
Practice Address - Country:US
Practice Address - Phone:312-731-1455
Practice Address - Fax:773-924-8450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1740333251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health