Organization
HARBOR HOUSE OF WHEELING IV, LLC
Active
Other names
Harbor House
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENJAMIN ISRAEL (MANAGER)
(847) 440-2660
Entity
Organization
Contact information
Practice address
760 MCHENRY RD, WHEELING, IL 60090-3861
(847) 465-1100
(847) 465-0146
Mailing address
760 MCHENRY RD, WHEELING, IL 60090-3861
(847) 465-1100
(847) 465-0146
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0055624
STATE LICENSE
IL
Enumeration date
01/15/2021
Last updated
01/15/2021
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