Provider Demographics
NPI:1639425697
Name:MARIANJOY AT PARK PLACE CHRISTIAN COMMUNITY
Entity Type:Organization
Organization Name:MARIANJOY AT PARK PLACE CHRISTIAN COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PFS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUE'
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-909-7378
Mailing Address - Street 1:1150 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5178
Mailing Address - Country:US
Mailing Address - Phone:630-909-7378
Mailing Address - Fax:630-909-7371
Practice Address - Street 1:1150 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5178
Practice Address - Country:US
Practice Address - Phone:630-909-7378
Practice Address - Fax:630-909-7371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-27
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility