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General NPI Number Information
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NPI Number | 1982658498
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Entity Type | Organization
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Legal Business Name | SL FOUNTAIN VIEW VILLAGE LLC
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 04/07/2009
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Provider Practice Location Address
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Address Line | 16455 E AVENUE OF THE FOUNTAINS
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City | FOUNTAIN HILLS
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State | AZ
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Zip | 85268-8307
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Country | US
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Telephone | 480-836-4800
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Fax | 480-836-4876
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Provider Business Mailing Address
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Address Line | 111 E WACKER DR SUITE 2200
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City | CHICAGO
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State | IL
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Zip | 60601-3713
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Country | US
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Telephone | 312-673-4333
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Fax | 312-673-4430
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Authorized Official
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Title or Position | DIR. MEDICARE REIMBURSEMENT
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Name | DEBRA A LICHTENWALD
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Credential |
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Telephone | 312-330-6434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number |
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License Number State |
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Taxonomy #4
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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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