Provider Demographics
NPI:1700593571
Name:CHURCHVIEW SUPPORTIVE LIVING PRESERVATION LP
Entity Type:Organization
Organization Name:CHURCHVIEW SUPPORTIVE LIVING PRESERVATION LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-362-3373
Mailing Address - Street 1:2626 W 63RD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-1655
Mailing Address - Country:US
Mailing Address - Phone:773-471-4444
Mailing Address - Fax:773-471-3935
Practice Address - Street 1:2626 W 63RD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-1655
Practice Address - Country:US
Practice Address - Phone:773-362-3373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility