Healthcare Provider Details

I. General information

NPI: 1265861603
Provider Name (Legal Business Name): PARK POINTE HEALTHCARE & REHABILITATION CENTER,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2013
Last Update Date: 02/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1223 EDGEWATER DR
MORRIS IL
60450-2504
US

IV. Provider business mailing address

1223 EDGEWATER DR
MORRIS IL
60450-2504
US

V. Phone/Fax

Practice location:
  • Phone: 815-416-6500
  • Fax:
Mailing address:
  • Phone: 815-416-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0052449
License Number StateIL

VIII. Authorized Official

Name: SUZANNE D DAY
Title or Position: ADMINISTRATOR
Credential:
Phone: 815-416-6216