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NPI 1023859048

NPI 1023859048 : CITADEL AT CASA SCALABRINI LLC : NORTHLAKE, IL

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General NPI Number Information
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    NPI Number           |    1023859048
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    Entity Type          |    Organization 
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    Legal Business Name  |    CITADEL AT CASA SCALABRINI LLC 
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Dates
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    Enumeration Date     |    06/04/2024
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    Last Update Date     |    11/04/2025
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Provider Practice Location Address
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    Address Line         |    480 N WOLF RD 
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    City                 |    NORTHLAKE
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    State                |    IL
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    Zip                  |    60164-1650
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    Country              |    US
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    Telephone            |    708-562-0040
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    Fax                  |    708-562-5180
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Provider Business Mailing Address
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    Address Line         |    3701 W LUNT AVE 
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    City                 |    LINCOLNWOOD
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    State                |    IL
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    Zip                  |    60712-2615
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    Country              |    US
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    Telephone            |    224-470-2044
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CFO
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    Name                 |     MARCELLA  GRAF 
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    Credential           |    
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    Telephone            |    224-470-2044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    314000000X
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    Taxonomy Name        |    Skilled Nursing Facility
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    License Number       |    
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    License Number State |    
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