Healthcare Provider Details

I. General information

NPI: 1215203476
Provider Name (Legal Business Name): BIOME INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2012
Last Update Date: 03/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3160 SUNSET HL
MOUNT MORRIS IL
61054-1000
US

IV. Provider business mailing address

3160 SUNSET HL
MOUNT MORRIS IL
61054-1000
US

V. Phone/Fax

Practice location:
  • Phone: 815-734-7297
  • Fax: 815-734-7297
Mailing address:
  • Phone: 815-734-7297
  • Fax: 815-734-7297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. ANGELIKA BRANDEIS
Title or Position: DIRECTOR
Credential:
Phone: 708-846-0896