| NPI | 1174525422 |
|---|---|
| Doing Business As | PROVIDENCE PALOS HEIGHTS |
| Entity Type | Organization |
| Authorized Contact | JOHANNA R ZANDSTRA Compliance Officer 708-342-8137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 0028605) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2015-09-23 |