Dove Mandela
Organization Active NPI Home Health Agency · Richton Park, IL
NPI 1013376185 · NPPES record last updated Sep 23, 2016
Key facts
- NPI
- 1013376185
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- DOVE MANDELA
- Practice address
- 22232 Rockingham Rd
Richton Park, IL 60471-1119 - Phone
- (708) 200-4979
- NPI assigned
- Feb 18, 2016
- Organization subpart
- No
Authorized official
- Name
- Mr. Malcolm Mandela Lee Sr.
- Title
- Owner/Director
- Phone
- (708) 200-4979
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Dove Mandela
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | IL | Yes |
Addresses
Primary practice location
22232 Rockingham Rd
Richton Park, IL 60471-1119
Mailing address
22232 Rockingham Rd
Richton Park, IL 60471-1119
Phone (708) 200-4979
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801344742 | Other | IL | NPPES |
Other names
- Dove Mandela Home Healthcare
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- Dove Mandela
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All providers in Richton Park, IL · Home Health Agency in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.