Provider Demographics
NPI:1962089367
Name:SWEET LOVE HOME CARE AGENCY INC.
Entity type:Organization
Organization Name:SWEET LOVE HOME CARE AGENCY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FELICITE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-913-4003
Mailing Address - Street 1:17070 SOUTH PARK AVE,
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-1735
Mailing Address - Country:US
Mailing Address - Phone:117-735-6182
Mailing Address - Fax:
Practice Address - Street 1:17070 SOUTH PARK AVE,
Practice Address - Street 2:
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-6047
Practice Address - Country:US
Practice Address - Phone:229-177-3561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL82344372001Medicaid
IL4000693OtherPUBLIC HEALTH LICENSE NUMBER