Organization
GRAND VICTORIAN OF SYCAMORE
Active
Parent organization
WELL PATH TENANT, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELL PATH TENANT, LLC
Authorized official
JEROME FINIS (MANAGER)
(847) 274-9596
Entity
Organization
Contact information
Practice address
1440 SOMONAUK ST, SYCAMORE, IL 60178-2916
(815) 895-1900
(815) 739-2253
Mailing address
200 E COURT ST STE 400, KANKAKEE, IL 60901-3848
(815) 935-1992
(815) 935-8380
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5107948
IDPH ASSISTED LIVING LICENSE
IL
Enumeration date
01/06/2022
Last updated
01/06/2026
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