Provider Demographics
NPI:1619672946
Name:WEALSHIRE REHAB, LLC
Entity Type:Organization
Organization Name:WEALSHIRE REHAB, LLC
Other - Org Name:WEALSHIRE CTR OF EXCELLENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-543-7200
Mailing Address - Street 1:12 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BEVERLY SHORES
Mailing Address - State:IN
Mailing Address - Zip Code:46301-0269
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 JAMESTOWN LN
Practice Address - Street 2:
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-2119
Practice Address - Country:US
Practice Address - Phone:224-543-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-04
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility