Provider Demographics
NPI:1790190577
Name:ARBA CARE CENTER OF COLFAX LLC
Entity Type:Organization
Organization Name:ARBA CARE CENTER OF COLFAX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-742-8822
Mailing Address - Street 1:134 N MCLEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-5169
Mailing Address - Country:US
Mailing Address - Phone:847-742-8822
Mailing Address - Fax:
Practice Address - Street 1:402 S HARRISON ST
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:IL
Practice Address - Zip Code:61728-7536
Practice Address - Country:US
Practice Address - Phone:309-723-2591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-30
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14-5992OtherMEDICARE PTAN