Organization
PHCH, LLC
Active
Other names
Colonial Hall Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARALEE RUNGEE (OFFICE MANAGER)
(847) 329-4100
Entity
Organization
Contact information
Practice address
515 S BUREAU VALLEY PKWY, PRINCETON, IL 61356-2203
(815) 875-3347
(815) 875-2012
Mailing address
7444 LONG AVE, SKOKIE, IL 60077-3214
(847) 329-4100
(847) 329-4900
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0049510
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14-5437
MEDICARE
—
Enumeration date
04/09/2008
Last updated
04/09/2008
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