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Organization

BETH ANNE EXTENDED LIVING

Active
Parent organization
BETHEL NEW LIFE, INC.
Other names
Beth Anne Place
Organization subpart
Yes

Provider details

NPI number
Legal business name
BETHEL NEW LIFE, INC.
Authorized official
MR. STEVEN D. MCCULLOUGH MBA (PRESIDENT AND CEO)
(773) 473-7870
Entity
Organization

Contact information

Practice address
1143 N LAVERGNE AVE, CHICAGO, IL 60651-3117
(773) 287-2711
(773) 473-7871
Mailing address
1143 N LAVERGNE AVE, CHICAGO, IL 60651-3117
(773) 287-2711
(773) 473-7871

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
01/29/2008
Last updated
01/30/2008
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