Provider Demographics
NPI:1992456719
Name:JEANE HELEN CARE & DEVELOPMENT CENTER
Entity type:Organization
Organization Name:JEANE HELEN CARE & DEVELOPMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLARETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-490-7645
Mailing Address - Street 1:PO BOX 1632
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-7632
Mailing Address - Country:US
Mailing Address - Phone:219-779-1936
Mailing Address - Fax:
Practice Address - Street 1:18241 OAKWOOD AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-2903
Practice Address - Country:US
Practice Address - Phone:219-779-1936
Practice Address - Fax:708-887-5879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty