Organization
WASHINGTON AND JANE SMITH COMMUNITY BEVERLY
Active
Other names
Smith Village
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND MARNERIS (CFO)
(773) 474-7350
Entity
Organization
Contact information
Practice address
11308 S OAKLEY AVE, CHICAGO, IL 60643-4112
(773) 474-7300
(773) 474-7342
Mailing address
2320 W 113TH PL, CHICAGO, IL 60643-4117
(773) 474-7300
(773) 474-7342
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0015032
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000015032
—
IL
Enumeration date
03/07/2006
Last updated
10/02/2013
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