Organization
RENVIVA NURSING HOME SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUAL TSAMOULOS (MEMBER)
(630) 427-8842
Entity
Organization
Contact information
Practice address
7444 W WILSON AVE, HARWOOD HEIGHTS, IL 60706-4549
(630) 427-8842
(708) 831-4253
Mailing address
74444 W. WILSON AVE, 108, HARWOOD HEIGHTS, IL 60706-4549
(630) 427-8842
(708) 831-4253
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
03/13/2018
Last updated
06/16/2018
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