Organization Name: | MANOR CARE OF KANKAKEE IL LLC |
NPI Number: | 1063459626 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BARRY A LAZARUS (VICE PRESIDENT - REIMBURSEMENTS) |
Mailing Address: | 900 W River Pl Kankakee |
State: | IL US |
Postal Code: | 609012932 |
Phone Number: | 8159331711 |
Fax Number: | 8159332065 |
NPI Enumeration Date: | 06/01/2006 |
NPI Last Update Date: | 04/13/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |