Organization
PROVIDENCE OPERATIONS, LLC
Active
Other names
Providence Palos Heights
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOHANNA R ZANDSTRA (COMPLIANCE OFFICER)
(708) 342-8137
Entity
Organization
Contact information
Practice address
13259 S CENTRAL AVE, PALOS HEIGHTS, IL 60463-2601
(708) 597-1000
(708) 597-1000
Mailing address
18601 N CREEK DR, TINLEY PARK, IL 60477-6397
(708) 342-8100
(708) 342-8006
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0028605
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
362382853002
—
IL
Enumeration date
06/01/2005
Last updated
09/23/2015
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