Provider Demographics
NPI:1235564204
Name:ASBURY PAVILION NURSING & REHABILITATION CENTER, LLC
Entity Type:Organization
Organization Name:ASBURY PAVILION NURSING & REHABILITATION CENTER, LLC
Other - Org Name:ASBURY GARDENS NURSING & REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAHTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-676-1700
Mailing Address - Street 1:212 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-1724
Mailing Address - Country:US
Mailing Address - Phone:630-896-1631
Mailing Address - Fax:
Practice Address - Street 1:212 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542-1724
Practice Address - Country:US
Practice Address - Phone:630-896-1631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility