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General NPI Number Information
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NPI Number | 1700593571
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Entity Type | Organization
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Legal Business Name | CHURCHVIEW SUPPORTIVE LIVING PRESERVATION LP
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Dates
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Enumeration Date | 11/01/2022
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 2626 W 63RD ST
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City | CHICAGO
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State | IL
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Zip | 60629-1655
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Country | US
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Telephone | 773-362-3373
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Fax |
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Provider Business Mailing Address
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Address Line | 2626 W 63RD ST
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City | CHICAGO
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State | IL
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Zip | 60629-1655
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Country | US
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Telephone | 773-471-4444
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Fax | 773-471-3935
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Authorized Official
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Title or Position | DIRECTOR
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Name | CHRISTINE JAMES
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Credential |
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Telephone | 773-362-3373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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