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Organization

ARBOR OF ITASCA, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
THOMAS ANNARELLA LNHA (ADMINISTRATOR)
(630) 773-9416
Entity
Organization

Contact information

Practice address
535 SOUTH ELM STREET, ITASCA, IL 60143-2187
(630) 773-9416
(630) 773-9434
Mailing address
535 S ELM ST, ITASCA, IL 60143-2187
(630) 773-9416
(630) 773-9434

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0019471
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0019471
IL
Enumeration date
12/11/2006
Last updated
08/22/2020
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