# CRESTVIEW SNF, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Illuminate HC Wyoming, SKLD Wyoming
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073002606
- **Authorized official:** YAIR ZUCKERMAN (MANAGER)
- **Authorized official phone:** (773) 517-4777

## Contact information

- **Practice address:** 625 36TH ST SW, WYOMING, MI 49509
- **Practice address phone:** (616) 531-0200
- **Mailing address:** 620 DAVIS ST STE 200, EVANSTON, IL 60201-4419

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 05/09/2018
- **Last updated:** 08/17/2018