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SHELTERING OAK

Intermediate Care Facility, Mental Illness

Island Lake, Illinois

Provider NPI: 1285759795

Organization Information:
Organization Name:  SHELTERING OAK


Practice Location:
27888 N BEECH ST  ISLAND LAKE, IL 60042 US
Tel: 847-526-3636  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y310500000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mental Illness
IL=========001

Other Provider Identifiers:

IssuerNumberStateType
FEDERAL NUMBER14E242IL01
MDS FACILITY ID KEYIL6008585IL01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




INTERMEDIATE CARE JOBS IL - Page 1



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