Provider Demographics
NPI:1689228603
Name:ELEVATE WOODVIEW NURSING AND REHAB LLC
Entity Type:Organization
Organization Name:ELEVATE WOODVIEW NURSING AND REHAB LLC
Other - Org Name:ELEVATE WOODVIEW NURSING AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:IYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-470-6512
Mailing Address - Street 1:8140 MCCORMICK BLVD STE 124
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-2920
Mailing Address - Country:US
Mailing Address - Phone:872-203-3994
Mailing Address - Fax:224-433-5153
Practice Address - Street 1:3420 E STATE BLVD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-5605
Practice Address - Country:US
Practice Address - Phone:260-484-3120
Practice Address - Fax:260-482-1434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-29
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility