Organization Name: | BLUE SKIES HOSPICE OF ILLINOIS INC |
NPI Number: | 1003917196 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LISA GUZMAN (DIRECTOR) |
Mailing Address: | 17825 Wentworth Ave Lansing |
State: | IL US |
Postal Code: | 604383913 |
Phone Number: | 7088891019 |
Fax Number: | 7084746492 |
NPI Enumeration Date: | 09/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 1712951 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |