Provider Demographics
NPI:1639954241
Name:ALGONQUIN SENIOR LIVING LEASECO, LLC
Entity Type:Organization
Organization Name:ALGONQUIN SENIOR LIVING LEASECO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-875-4500
Mailing Address - Street 1:400 LOCUST ST STE 820
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-2334
Mailing Address - Country:US
Mailing Address - Phone:515-381-7660
Mailing Address - Fax:
Practice Address - Street 1:2001 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-1300
Practice Address - Country:US
Practice Address - Phone:847-458-6800
Practice Address - Fax:847-984-1895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility