Provider Demographics
NPI:1467915488
Name:ELEVATE SAINT ANDREW LIVING COMMUNITY LLC
Entity Type:Organization
Organization Name:ELEVATE SAINT ANDREW LIVING COMMUNITY LLC
Other - Org Name:GLEN SAINT ANDREW LIVING COMMUNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAKOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-470-6513
Mailing Address - Street 1:7000 N NEWARK AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-4577
Mailing Address - Country:US
Mailing Address - Phone:847-647-8332
Mailing Address - Fax:
Practice Address - Street 1:7000 N NEWARK AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-4577
Practice Address - Country:US
Practice Address - Phone:847-647-8332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility