Healthcare Provider Details

I. General information

NPI: 1124733928
Provider Name (Legal Business Name): ROSELAND SLF, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2023
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10450 S MICHIGAN AVE
CHICAGO IL
60628-2751
US

IV. Provider business mailing address

4105 OAKTON STREET
SKOKIE IL
60076
US

V. Phone/Fax

Practice location:
  • Phone: 773-468-6400
  • Fax:
Mailing address:
  • Phone: 847-423-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: ELCHANAN FINESTONE
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 847-423-0900