Provider Demographics
NPI:1073805719
Name:ALC OPERATING, LLC
Entity Type:Organization
Organization Name:ALC OPERATING, LLC
Other - Org Name:INWOOD HILLS ESTATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEVONOWICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-257-8888
Mailing Address - Street 1:W140N8981 LILLY RD
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-2325
Mailing Address - Country:US
Mailing Address - Phone:262-257-8809
Mailing Address - Fax:262-502-3730
Practice Address - Street 1:4010 S IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46614-2200
Practice Address - Country:US
Practice Address - Phone:574-291-2222
Practice Address - Fax:574-231-9401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN004697310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility