Provider Demographics
NPI:1073714341
Name:ARBOUR HEALTH CARE
Entity Type:Organization
Organization Name:ARBOUR HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PATTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-465-7751
Mailing Address - Street 1:1512 W FARGO AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-1805
Mailing Address - Country:US
Mailing Address - Phone:773-465-7751
Mailing Address - Fax:773-465-2104
Practice Address - Street 1:1512 W FARGO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-1805
Practice Address - Country:US
Practice Address - Phone:773-465-7751
Practice Address - Fax:773-465-2104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL21767314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility