Organization
WOODSTOCK CHRISTIAN LIFE SERVICES
Active
Other names
Hearthstone Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW BOSWELL (VICE PRESIDENT OF FINANCE)
(716) 338-9766
Entity
Organization
Contact information
Practice address
920 N SEMINARY AVE, WOODSTOCK, IL 60098-2996
(815) 334-6200
(815) 338-8846
Mailing address
318 CHRISTIAN WAY, WOODSTOCK, IL 60098-2912
(815) 334-6200
(815) 206-0472
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
6009310
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14A349
FEDERAL PROVIDER NUMBER
IL
01
—
6009310
FACILITY NUMBER
IL
Enumeration date
04/23/2007
Last updated
07/13/2022
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