Organization
CRYSTAL PINES REHABILITATION AND HEALTH CARE CENTER, LLC
Active
Other names
CRYSTAL PINES REHABILITATION & HEALTH CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH C TUTERA (PRESIDENT, CEO)
(816) 444-0900
Entity
Organization
Contact information
Practice address
335 ILLINOIS ST, CRYSTAL LAKE, IL 60014-3618
(815) 459-7791
(815) 459-7680
Mailing address
335 ILLINOIS ST, CRYSTAL LAKE, IL 60014-3618
(815) 459-7791
(815) 459-7680
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0045062
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431821821001
—
IL
Enumeration date
07/21/2005
Last updated
04/23/2021
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