Contract Details
Dependicare Home Health Inc
Facility name
Dependicare Home Health Inc
Provider ID
P000004108
NPI
1245336684
Tax ID
363259064
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1250 Larry Power Rd
Bourbonnais, IL 60914
United States
County
Kankakee
Phone
8009791250 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address