Basic Information
Provider Information
NPI: 1588680243
EntityType: 2
ReplacementNPI:  
OrganizationName: PRAC HOLDINGS, INC.
LastName:  
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Mailing Information
Address1: 2300 WARRENVILLE RD STE 100
Address2:  
City: DOWNERS GROVE
State: IL
PostalCode: 605151717
CountryCode: US
TelephoneNumber: 6302963400
FaxNumber:  
Practice Location
Address1: 3000 EL CAMINO REAL STE 200
Address2:  
City: PALO ALTO
State: CA
PostalCode: 943062100
CountryCode: US
TelephoneNumber: 6505681629
FaxNumber: 6505681643
Other Information
ProviderEnumerationDate: 07/15/2006
LastUpdateDate: 08/17/2021
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: ANDERSON
AuthorizedOfficialFirstName: DARBY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: EVP, CHIEF STRATEGY OFFICER
AuthorizedOfficialTelephone: 6302963591
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: ADDUS HEALTHCARE INC
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NPICertificationDate: 08/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000X  N AgenciesHome Health 
253Z00000X  Y AgenciesIn Home Supportive Care 

No ID Information.


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