Provider Demographics
NPI:1982014486
Name:CARTER AID OPCO LLC
Entity Type:Organization
Organization Name:CARTER AID OPCO LLC
Other - Org Name:CARTER PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-725-7000
Mailing Address - Street 1:330 N WABASH AVE
Mailing Address - Street 2:SUITE 3700
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3586
Mailing Address - Country:US
Mailing Address - Phone:312-725-7000
Mailing Address - Fax:312-332-5902
Practice Address - Street 1:1028 JOANN DR
Practice Address - Street 2:
Practice Address - City:BLAIR
Practice Address - State:NE
Practice Address - Zip Code:68008-2747
Practice Address - Country:US
Practice Address - Phone:877-655-9942
Practice Address - Fax:312-332-5431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-06
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEALF025310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility