17400 S KEDZIE AVE LLC; NPI #1578321311

Contact Information

17400 S KEDZIE AVE LLC

17400 KEDZIE AVE
HAZEL CREST, IL 60429-1600

Phone: 618-780-3256
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Assisted Living Facility	310400000X
Alzheimer Center /Dementia Center/Dementia Special Care Unit	311500000X

Indicates primary specialty

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NPI Profile & details for 17400 S KEDZIE AVE LLC

NPI Number	`1578321311`
LBN Legal business name	17400 S KEDZIE AVE LLC
Authorized official	ASHLEY PETERSON - (VICE PRESIDENT)
Entity	Organization
Organization subpart ¹	No
Enumeration date	03/07/2024
Last updated	05/17/2024 - About 2 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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17400 S KEDZIE AVE LLC

Contact Information

Specialty

Assisted Living Facility

Alzheimer Center /Dementia Center/Dementia Special Care Unit

NPI Profile & details for 17400 S KEDZIE AVE LLC

Reviews for 17400 S KEDZIE AVE LLC