NPI | 1538725841 |
---|---|
Doing Business As | AVANTARA LAKE NORDEN |
Entity Type | Organization |
Authorized Contact | CHAIM RAJCHENBACH CEO/Principal 847-679-9797 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility |
Enumeration Date | 2019-05-13 |
Last Update Date | 2019-05-13 |