Provider Demographics
NPI:1922152859
Name:BRITISH HOME FOR RETIRED MEN AND WOMEN
Entity Type:Organization
Organization Name:BRITISH HOME FOR RETIRED MEN AND WOMEN
Other - Org Name:THE BRITISH HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-485-0135
Mailing Address - Street 1:8700 31ST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60513-1000
Mailing Address - Country:US
Mailing Address - Phone:708-485-0135
Mailing Address - Fax:708-485-8844
Practice Address - Street 1:8700 31ST ST
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:IL
Practice Address - Zip Code:60513-1000
Practice Address - Country:US
Practice Address - Phone:708-485-0135
Practice Address - Fax:708-485-8844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1676854314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL145827Medicare ID - Type Unspecified