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NPI Code Detail

MEDICARE: BRIA OF WOODRIVER LP

MEDICARE: BRIA OF WOODRIVER LP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1023748597
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIA OF WOODRIVER LP
Provider Business Mailing Address
First Line : 5151 CHURCH ST
Second Line :
City : SKOKIE
State : IL
Zip : 60077-1123
Country : US
Telephone Number : 847-933-9200
Fax Number : 847-933-9765
Provider Business Practice Location Address
First Line : 393 E EDWARDSVILLE RD
Second Line :
City : WOOD RIVER
State : IL
Zip : 62095-1646
Country : US
Telephone Number : 618-259-4111
Fax Number : 618-259-5791
Authorized Official
Title or Position : CFO
Name : AVRUM WEINFELD
Credential :
Telephone Number : 847-933-9200
Provider Enumeration Date : 06/16/2022
Last Update Date : 10/16/2024

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Directions to “BRIA OF WOODRIVER LP ” Practice Location

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