Provider Demographics
NPI:1376978106
Name:ST. ANTHONY SLF, LLC
Entity Type:Organization
Organization Name:ST. ANTHONY SLF, LLC
Other - Org Name:ST. ANTHONY OF LANSING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ZACHARIAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-981-8432
Mailing Address - Street 1:3025 SPRING LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-4400
Mailing Address - Country:US
Mailing Address - Phone:708-474-6100
Mailing Address - Fax:
Practice Address - Street 1:3025 SPRING LAKE DR
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-4400
Practice Address - Country:US
Practice Address - Phone:708-474-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility