Provider Demographics
NPI:1447582572
Name:HR MANOR CARE HEALTH SERVICES
Entity Type:Organization
Organization Name:HR MANOR CARE HEALTH SERVICES
Other - Org Name:HR MANOR CARE HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REHAB
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:CZUBA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:708-233-5116
Mailing Address - Street 1:6300 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2256
Mailing Address - Country:US
Mailing Address - Phone:708-233-5116
Mailing Address - Fax:708-599-8820
Practice Address - Street 1:6300 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2256
Practice Address - Country:US
Practice Address - Phone:708-233-5116
Practice Address - Fax:708-599-8820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160005381314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility