Organization
WATERFRONT TERRACE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARSHALL A MAUER (SECRETARY-TREASURER)
(847) 679-8219
Entity
Organization
Contact information
Practice address
7750 S SOUTH SHORE DR, CHICAGO, IL 60649-4434
(773) 731-4200
Mailing address
3359 MAIN ST, SKOKIE, IL 60076-2432
(847) 679-8219
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0028076
IL
Other
Enumeration date
12/26/2005
Last updated
11/28/2011
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