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NPI Code Detail

MEDICARE: CENTRAL NURSING HOME LLC

MEDICARE: CENTRAL NURSING HOME LLC
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 : 1205222379
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRAL NURSING HOME LLC
Provider Business Mailing Address
First Line : 6500 N HAMLIN AVE
Second Line :
City : LINCOLNWOOD
State : IL
Zip : 60712-3904
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2450 N CENTRAL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-1316
Country : US
Telephone Number : 847-679-7484
Fax Number :
Authorized Official
Title or Position : BOOKKEEPER
Name : DAVID LUBOWSKY
Credential :
Telephone Number : 847-679-7484
Provider Enumeration Date : 04/15/2015
Last Update Date : 08/08/2019

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Directions to “CENTRAL NURSING HOME LLC ” Practice Location

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