Organization
BRIGHTVIEW CARE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOSHE DAVIS (ADMINISTRATOR)
(773) 463-1313
Entity
Organization
Contact information
Practice address
4538 N BEACON ST, CHICAGO, IL 60640-5519
(773) 275-7200
Mailing address
3553 W PETERSON AVE, SUITE 300, CHICAGO, IL 60659-3200
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0030551
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1137
BLUE CROSS BLUE SHIELD
IL
Enumeration date
11/07/2006
Last updated
08/22/2020
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