Provider Demographics
NPI:1730127192
Name:FRANCISCAN COMMUNITIES, INC.
Entity Type:Organization
Organization Name:FRANCISCAN COMMUNITIES, INC.
Other - Org Name:ST. JAMES MANOR & VILLA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VP/CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:ZIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-647-6500
Mailing Address - Street 1:1055 175TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-4610
Mailing Address - Country:US
Mailing Address - Phone:708-647-6500
Mailing Address - Fax:708-647-6982
Practice Address - Street 1:1251 E RICHTON RD
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:IL
Practice Address - Zip Code:60417-1623
Practice Address - Country:US
Practice Address - Phone:708-672-6700
Practice Address - Fax:708-672-4939
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANCISCAN SISTERS OF CHICAGO SERVICE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-04
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL510096310400000X
IL0045435314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========004MedicaidILLINOIS MEDICAID
IL=========004Medicaid