Provider Demographics
NPI:1376830992
Name:LEXINGTON HEALTH CARE CENTER
Entity Type:Organization
Organization Name:LEXINGTON HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:MROWIEC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-776-7279
Mailing Address - Street 1:2100 S FINLEY RD
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4830
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2100 S FINLEY RD
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4830
Practice Address - Country:US
Practice Address - Phone:630-495-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-03
Last Update Date:2011-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.005763314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility