Provider Demographics
NPI:1851849269
Name:ALDEN COURTS OF WATERFORD, L.L.C.
Entity Type:Organization
Organization Name:ALDEN COURTS OF WATERFORD, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:AVELINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-724-6376
Mailing Address - Street 1:1991 RANDI DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-4757
Mailing Address - Country:US
Mailing Address - Phone:630-851-1466
Mailing Address - Fax:
Practice Address - Street 1:4200 W. PETERSON AVE. SUITE 140
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-6074
Practice Address - Country:US
Practice Address - Phone:773-286-6622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility