| Senior Home Sharing | |
|
1910 S Highland Ave Ste 135 Lombard IL 60148-6147 | |
| (630) 407-0440 | |
| Not Available |
| Full Name | Senior Home Sharing |
|---|---|
| Speciality | Counselor |
| Location | 1910 S Highland Ave Ste 135, Lombard, Illinois |
| Authorized Official Name and Position | Rita Brosnan (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6304070440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Home Sharing 1910 S Highland Ave Ste 135 Lombard IL 60148-6147 Ph: (630) 407-0440 | Senior Home Sharing 1910 S Highland Ave Ste 135 Lombard IL 60148-6147 Ph: (630) 407-0440 |
| NPI Number | 1174194765 |
|---|---|
| Provider Enumeration Date | 07/06/2021 |
| Last Update Date | 02/02/2022 |
| Certification Date | 02/02/2022 |
| Medicare PECOS PAC ID | 7618361023 |
|---|---|
| Medicare Enrollment ID | O20220301002037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174194765 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 310400000X | Assisted Living Facility | (* (Not Available)) | Secondary |
| Provider Name | Melissa Kroll |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538452818 PECOS PAC ID: 6800021973 Enrollment ID: I20131025000414 |
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