Contract Details
Facility name
Dependicare Home Health Inc
Provider ID
P000005716
NPI
1962508382
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
1815 Gardner Rd
Broadview, IL 60155
United States
County
Cook
Phone
7083457400 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address