Provider Demographics
NPI:1407090558
Name:LONG FAMILY DEVELOPMENT LLC
Entity Type:Organization
Organization Name:LONG FAMILY DEVELOPMENT LLC
Other - Org Name:HARVEST VIEW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:815-426-2000
Mailing Address - Street 1:100 HARVEST VIEW LN
Mailing Address - Street 2:
Mailing Address - City:HERSCHER
Mailing Address - State:IL
Mailing Address - Zip Code:60941-4404
Mailing Address - Country:US
Mailing Address - Phone:815-426-2000
Mailing Address - Fax:
Practice Address - Street 1:100 HARVEST VIEW LN
Practice Address - Street 2:
Practice Address - City:HERSCHER
Practice Address - State:IL
Practice Address - Zip Code:60941-4404
Practice Address - Country:US
Practice Address - Phone:815-426-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL5103004310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility