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NPI Code Detail

MEDICARE: ORCHARD GROVE NURSING & REHAB CENTER LLC

MEDICARE: ORCHARD GROVE NURSING & REHAB CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilityL2523908MI

General Provider Information

NPI Number : 1962837542
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORCHARD GROVE NURSING & REHAB CENTER LLC
Provider Business Mailing Address
First Line : 7383 N LINCOLN AVE
Second Line : SUITE 100
City : LINCOLNWOOD
State : IL
Zip : 60712-1734
Country : US
Telephone Number : 847-440-2233
Fax Number : 847-430-5283
Provider Business Practice Location Address
First Line : 1385 E EMPIRE AVE
Second Line :
City : BENTON HARBOR
State : MI
Zip : 49022-2037
Country : US
Telephone Number : 269-925-0033
Fax Number : 269-925-2019
Authorized Official
Title or Position : MANAGER
Name : MR. MOSHE DAVID ARYEH
Credential :
Telephone Number : 773-793-0167
Provider Enumeration Date : 09/13/2013
Last Update Date : 06/22/2015

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