CHURCHVIEW SUPPORTIVE LIVING COMMUNITY NPI 1003002650
Assisted Living Facility in Chicago, IL
About CHURCHVIEW SUPPORTIVE LIVING COMMUNITY
Churchview Supportive Living Community is a provider established in Chicago, Illinois specializing in assisted living facility. The NPI number of Churchview Supportive Living Community is 1003002650 and was assigned on September 2007. The practitioner's primary taxonomy code is 310400000X with license number 0=========001 (IL). The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Ms. Laura Kelly (Administrator)
| NPI | 1003002650 |
| Provider Name | CHURCHVIEW SUPPORTIVE LIVING COMMUNITY |
| Provider Location Address | 2626 W 63RD ST CHICAGO, IL 60629 |
| Provider Mailing Address | 2626 W 63RD ST CHICAGO, IL 60629 |
| NPI Entity Type | Organization |
| Is Sole Proprietor? | N/A |
| Is Organization Subpart? | No |
| Enumeration Date | 09-18-2007 |
| Last Update Date | 04-20-2008 |
Primary Taxonomy
| Taxonomy Code | 310400000X |
| Classification | Assisted Living Facility |
| Type | Nursing & Custodial Care Facilities |
| License No. | 0=========001 |
| License State | IL |
| Taxonomy Description | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
Business Address
CHURCHVIEW SUPPORTIVE LIVING COMMUNITY
2626 W 63RD ST
CHICAGO, IL
ZIP 60629
Phone: (773) 471-4444
Fax: (773) 471-3935
Mailing Address
CHURCHVIEW SUPPORTIVE LIVING COMMUNITY
2626 W 63RD ST
CHICAGO, IL
ZIP 60629
Phone: (773) 471-4444
Fax: (773) 471-3935
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.