Organization
LAUREATE BOURBONNAIS OPERATIONS LLC
Active
Other names
Bourbonnais Terrace
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAUN AHMAD (MANAGER)
(704) 426-8849
Entity
Organization
Contact information
Practice address
133 MOHAWK DR, BOURBONNAIS, IL 60914-1349
(815) 937-4790
(815) 937-0432
Mailing address
13024 BALLANTYNE CORPORATE PL STE 425, CHARLOTTE, NC 28277-4420
(704) 426-8849
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
—
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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