Provider Demographics
NPI:1497469563
Name:UTICA SKILLED NURSING FACILITY LLC
Entity Type:Organization
Organization Name:UTICA SKILLED NURSING FACILITY LLC
Other - Org Name:HARMONY UTICA RIDGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:CHAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJCHENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-676-5331
Mailing Address - Street 1:3450 OAKTON ST
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-2951
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3800 COMMERCE BLVD
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-3495
Practice Address - Country:US
Practice Address - Phone:563-344-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility