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:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
27888 N BEECH ST ISLAND LAKE, IL 60042 US
Tel: 847-526-3636 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 310500000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mental Illness | IL | =========001 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
FEDERAL NUMBER | 14E242 | IL | 01 |
MDS FACILITY ID KEY | IL6008585 | IL | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin