Organization
ALDEN ESTATES OF COUNTRYSIDE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN AVELINO (ACCOUNTS RECEIVABLE MANAGER)
(773) 724-6376
Entity
Organization
Contact information
Practice address
1130 COLLINS RD, JEFFERSON, WI 53549-2939
(920) 674-3170
Mailing address
4200 W PETERSON AVE, CHICAGO, IL 60646-6074
(773) 724-6376
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
06/11/2019
Last updated
06/11/2019
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