Organization
NORWEGIAN LUTHERAN BETHESDA HOME ASSOCIATION
Active
Other names
Bethesda Home and Retirement Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIE BOGGESS NHA (CEO)
(773) 622-6144
Entity
Organization
Contact information
Practice address
2833 N NORDICA AVE, CHICAGO, IL 60634-4726
(773) 622-6144
(773) 622-8261
Mailing address
2833 N NORDICA AVE, CHICAGO, IL 60634-4726
(773) 622-6144
(773) 622-8261
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0012229
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01146
BCBS PROVIDER #
IL
01
—
5034709
AETNA PROVIDER #
IL
Enumeration date
10/04/2005
Last updated
02/08/2012
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