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General NPI Number Information
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NPI Number | 1467449280
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Entity Type | Organization
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Legal Business Name | ALDEN-VALLEY RIDGE REHABILITATION AND HEALTH CARE CENTER, INC.
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 275 E ARMY TRAIL RD
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2135
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Country | US
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Telephone | 630-893-9616
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Fax | 630-924-1059
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Provider Business Mailing Address
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Address Line | 4200 W PETERSON AVE SUITE 140
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City | CHICAGO
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State | IL
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Zip | 60646-6074
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Country | US
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Telephone | 773-286-6622
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Fax | 773-286-2150
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Authorized Official
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Title or Position | PRESIDENT
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Name | FLOYD A SCHLOSSBERG
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Credential |
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Telephone | 773-286-6622
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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 | 0036640
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License Number State | IL
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