Organization
BETHSHAN ASSOCIATION
Active
Other names
Tibstra House
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN J GOUDZWAARD (DIRECTOR OF FINANCE)
(708) 371-0800
Entity
Organization
Contact information
Practice address
271 E 161ST ST, SOUTH HOLLAND, IL 60473-1400
(708) 596-4442
(708) 596-4486
Mailing address
12927 S MONITOR AVE, PALOS HEIGHTS, IL 60463-2434
(708) 371-0800
(708) 371-0833
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0035196
IL
Other
Enumeration date
01/30/2007
Last updated
08/15/2016
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