Organization
PRESBYTERIAN HOMES
Active
Other names
Lake Forest Place
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT E LANDSMAN (VICE PRESIDENT OF FINANCE)
(847) 492-4859
Entity
Organization
Contact information
Practice address
1100 PEMBRIDGE DRIVE, LAKE FOREST, IL 60045
(847) 604-6700
(847) 570-3426
Mailing address
3200 GRANT STREET, ATTN ACCOUNTING DEPARTMENT, EVANSTON, IL 60201
(847) 492-4871
(847) 570-3426
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
310400000X
Assisted Living Facility
—
—
314000000X
Skilled Nursing Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04932281
BLUE CROSS BLUE SHIELD ILLINOIS
IL
Enumeration date
03/27/2006
Last updated
06/04/2008
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