Organization
THE ESTATES OF SPANISH LAKE, LLC
Active
Other names
The Estates of Spanish Lake
Organization subpart
No
Provider details
NPI number
Authorized official
TUVIYAH SPECTOR (MANAGING MEMBER)
(773) 322-0387
Entity
Organization
Contact information
Practice address
610 PRIGGE RD, SAINT LOUIS, MO 63138-3543
(610) 828-8700
Mailing address
5940 W TOUHY AVE, STE 350, NILES, IL 60714-4638
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
10/21/2014
Last updated
03/09/2016
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