Provider Demographics
NPI: | 1922354711 |
---|---|
Name: | TIMOTHY PLACE, NFP |
Entity Type: | Organization |
Organization Name: | TIMOTHY PLACE, NFP |
Other - Org Name: | PARK PLACE CHRISTIAN COMMUNITY |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | ATTORNEY |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | FRANCES |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MEEHAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 312-521-2467 |
Mailing Address - Street 1: | 1150 S EUCLID AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | ELMHURST |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60126-5178 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 630-936-4100 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1150 S EUCLID AVE |
Practice Address - Street 2: | |
Practice Address - City: | ELMHURST |
Practice Address - State: | IL |
Practice Address - Zip Code: | 60126-5178 |
Practice Address - Country: | US |
Practice Address - Phone: | 630-936-4100 |
Practice Address - Fax: | 630-936-4150 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-07-30 |
Last Update Date: | 2012-07-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
IL | 314000000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 314000000X | Nursing & Custodial Care Facilities | Skilled Nursing Facility |