Healthcare Provider Details

I. General information

NPI: 1568635209
Provider Name (Legal Business Name): CONTINENTAL NURSING AND REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2008
Last Update Date: 04/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5336 N WESTERN AVE
CHICAGO IL
60625-2310
US

IV. Provider business mailing address

5336 N WESTERN AVE
CHICAGO IL
60625-2310
US

V. Phone/Fax

Practice location:
  • Phone: 773-271-5600
  • Fax:
Mailing address:
  • Phone: 773-271-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. MOISHE GUBIN
Title or Position: OWNER, CFO
Credential:
Phone: 219-661-8590