Supported Independence
NPI #1467729137 in Hazel Crest, Illinois
Provider Information
- NPI Number
- 1467729137
- Entity Type
- Organization
- Organization Name
- Supported Independence
- Primary Specialty
- Home Health
- Enumeration Date
- Nov 24, 2011
- Last Updated
- Nov 24, 2011
Practice Location
- Address
- 17009 ELM DR
- City
- Hazel Crest
- State
- Illinois
- ZIP Code
- 60429-1047
- Phone
- (630) 667-7370
Authorized Official
- Name
- MRS. JESSICA LUCKETT
- Title
- PRESIDENT
- Phone
- (630) 667-7370
Specialties & Taxonomy Codes
| Specialty |
|---|
| Home Health |
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