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Organization
LAUREATE BOURBONNAIS OPERATIONS LLC
Active
Organization
LAUREATE BOURBONNAIS OPERATIONS LLC
Active
Other names
Bourbonnais Terrace
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAUN AHMAD (MANAGER)
(704) 426-8849
Entity
Organization
Contact information
Practice address
133 MOHAWK DR, BOURBONNAIS, IL 60914-1349
(815) 937-4790
(815) 937-0432
Mailing address
13024 BALLANTYNE CORPORATE PL STE 425, CHARLOTTE, NC 28277-4420
(704) 426-8849
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
—
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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