Organization
MONTCLARE SENIOR RESIDENCES SLF OF LAWNDALE LLC
Active
Other names
Montclare Senior Residences SLF of Lawndale
Organization subpart
No
Provider details
NPI number
Authorized official
JOELLEN BLEAVINS (PRESIDENT OF MANAGEMENT AGENT)
(815) 935-1992
Entity
Organization
Contact information
Practice address
4339 WEST 18TH PLACE, CHICAGO, IL 60623
(773) 277-0288
(773) 277-0312
Mailing address
4339 WEST 18TH PLACE, CHICAGO, IL 60623
(773) 277-0288
(773) 277-0312
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
12/29/2016
Last updated
12/29/2016
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