Provider Demographics
NPI:1871342121
Name:HARMONY CARE ILLINOIS LLC
Entity type:Organization
Organization Name:HARMONY CARE ILLINOIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTONY
Authorized Official - Middle Name:
Authorized Official - Last Name:WANJIKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-931-0900
Mailing Address - Street 1:3 PERSIMMON LN
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-1122
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 N CENTER DR STE B2A
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-5946
Practice Address - Country:US
Practice Address - Phone:217-931-0900
Practice Address - Fax:314-261-9111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-17
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care