In Home Health LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

2001311 Issued in IL

Legal business name

IN HOME HEALTH LLC

Doing business as

ProMedica Hospice (Fairview Heights)
ProMedica Hospice (Springfield)

Practice address

333 Salem PL
Suite 165
Fairview Heights, IL 62208-1341

Phone

(618) 632-0304

Fax

(618) 632-0364

NPI assigned

May 25, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Martin D Allen

Title

Director

Phone

(419) 252-5734

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 2

• ProMedica Hospice (Fairview Heights) Doing business as
• ProMedica Hospice (Springfield) Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Manorcare Health Services LLC

  dba ProMedica Skilled Nursing and Rehabilitation (Lely Palms)

  • Skilled Nursing Facility
  • Naples, FL
  • NPI 1366499535

  Member Of

  NPD member

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Southerncare, Inc.

  dba Heartland

  • Community Based Hospice Care Agency
  • Fairview Heights, IL
  • NPI 1154020659

  Sold to, 2023-11-01

  CMS change of ownership

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

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649980800000",
    "number": "1700105152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "address_2": "DEAN SHIPMAN",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-254-7841",
            "fax_number": "419-254-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SALEM PL",
            "address_2": "SUITE 165",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081341",
            "telephone_number": "618-632-0304",
            "fax_number": "618-632-0364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1999 Wabash Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627045375",
            "country_code": "US",
            "telephone_number": "618-632-0304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IN HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-25",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IL",
            "license": "2001311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700105152",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Fairview Heights)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ProMedica Hospice (Springfield)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Morristine Hunter
• Sophia Loren Hunter
• Eva A Hurst, M.D.
• I Think I Can Learning Center, Inc.
• Ebele N Iloabachie
• In Home Health, LLC (ProMedica Hospice (Fairview Heights))
• Maci Ingram
• Itic Support Services Group LLC (ITIC Support Services)
• Hailey E Ivy
• Diamond Jackson

• Community Based Hospice Care Agency in Fairview Heights, IL
• Providers in Fairview Heights, IL by specialty
• Community Based Hospice Care Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.