# PRESBYTERIAN HOMES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lake Forest Place
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831169945
- **Authorized official:** MR. ROBERT E LANDSMAN (VICE PRESIDENT OF FINANCE)
- **Authorized official phone:** (847) 492-4859

## Contact information

- **Practice address:** 1100 PEMBRIDGE DR, LAKE FOREST, IL 60045
- **Practice address phone:** (847) 604-6700
- **Practice address fax:** (847) 604-6604
- **Mailing address:** 3200 GRANT ST, ATTN ACCOUNTING DEPARTMENT, EVANSTON, IL 60201
- **Mailing address phone:** (847) 492-4871
- **Mailing address fax:** (847) 570-3426

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 0044065 | IL | Yes |
| 310400000X | Assisted Living Facility | 0044065 | IL | — |
| 314000000X | Skilled Nursing Facility | 0044065 | IL | — |

## Other

- **Enumeration date:** 01/23/2006
- **Last updated:** 08/12/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2100 | BCBS | — |
| 01 | — | 4932281 | BCBS | — |