| NPI | 1477502672 |
|---|---|
| Doing Business As | PROVENA HOME HEALTH INC WAUKEGAN |
| Entity Type | Organization |
| Authorized Contact | MARGARET C GLEASON President CEO 815-806-2364 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: IL 1010261) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2009-09-16 |