Living Waters Home Health Care Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1010420 Issued in IL

Legal business name

LIVING WATERS HOME HEALTH CARE INC

Practice address

4001 W Devon Ave
Suite 406
Chicago, IL 60646-4523

Phone

(773) 202-8043

Fax

(773) 202-8048

NPI assigned

Apr 11, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Marlyn B Bermudez, R.N.

Title

Administrator

Phone

(773) 202-8043

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188518400000",
    "number": "1386867935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 W DEVON AVE",
            "address_2": "SUITE 406",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464523",
            "telephone_number": "773-202-8043",
            "fax_number": "773-202-8048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 W DEVON AVE",
            "address_2": "SUITE 406",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464523",
            "telephone_number": "773-202-8043",
            "fax_number": "773-202-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WATERS HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-08-31",
        "status": "A",
        "authorized_official_last_name": "BERMUDEZ",
        "authorized_official_first_name": "MARLYN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "773-202-8043",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.