Organization Name: | DUBOIS-DOUGLAS, INC. |
NPI Number: | 1982046355 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FUNMI MARTINS-MENSAH (EXECUTIVE DIRECTOR) |
Mailing Address: | 1016 W Jackson Blvd Chicago |
State: | IL US |
Postal Code: | 606072914 |
Phone Number: | 3122888640 |
Fax Number: | 3122431516 |
NPI Enumeration Date: | 07/25/2013 |
NPI Last Update Date: | 05/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | 12HM519014 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |