Provider Demographics
NPI:1790021319
Name:WESTLAKE NURSING AND REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:WESTLAKE NURSING AND REHABILITATION CENTER LLC
Other - Org Name:THE ORCHARDS OF WESTLAKE LIVING & REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REUVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVITIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-676-5342
Mailing Address - Street 1:7040 N RIDGEWAY AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-2620
Mailing Address - Country:US
Mailing Address - Phone:847-679-9797
Mailing Address - Fax:847-679-1126
Practice Address - Street 1:4000 CROCKER RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-6312
Practice Address - Country:US
Practice Address - Phone:440-892-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-31
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
365808Medicare Oscar/Certification