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Organization

EDEN SUPPORTIVE LIVING BROZEVILLE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL J HAMBLET (PRESIDENT)
(360) 903-8753
Entity
Organization

Contact information

Practice address
3800 S KING DR, CHICAGO, IL 60653-1785
(630) 903-8753
Mailing address
1 E ERIE ST STE 525-4833, CHICAGO, IL 60611-2740
(630) 903-8753

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
10/07/2025
Last updated
10/07/2025
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