NPI | 1073618997 |
---|---|
Doing Business As | BETHANY COVENANT VILLAGE |
Entity Type | Organization |
Authorized Contact | RICK K FISK President 773-878-2295 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MN No numbers used) |
Enumeration Date | 2006-09-14 |
Last Update Date | 2020-08-22 |