Marianjoy at Providence Victorian Village
NPI #1174912562 in Homer Glen, Illinois
Provider Information
- NPI Number
- 1174912562
- Entity Type
- Organization
- Organization Name
- Marianjoy at Providence Victorian Village
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Jan 22, 2015
- Last Updated
- Jan 22, 2015
Practice Location
- Address
- 12525 RENAISSANCE CIR
- City
- Homer Glen
- State
- Illinois
- ZIP Code
- 60491-5896
- Phone
- (708) 590-5050
Authorized Official
- Name
- MS. LAURA J. BOOKER
- Title
- PFS CONTRACTED LEAD
- Phone
- (630) 909-7374
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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