Glenwood House Residential Care, Inc.

LBN: Glenwood House Residential Care, Inc.
Glenwood House Residential Care, Inc. is an health care organization with primary practice located at 300 W 12Th St , Streator IL 61364-3301. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Glenwood House Residential Care, Inc. can be contacted via phone (815) 673-1182, or through Gomes, Ralph S via phone (815) 673-1182.

Contact Information

Primary practice address
300 W 12Th St Streator IL 61364-3301
Phone: (815) 673-1182
Fax: (815) 673-3231
Website:
Map and Directions
Authorized official contact:
Name: Gomes, Ralph S
Phone: (815) 673-1182

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 0037192 Illinois

Profile Details

NPI number 1205014727
LBN Legal business name Glenwood House Residential Care, Inc.
DBA Doing business as
Authorized official Gomes, Ralph S
Entity Organization
Organization subpart 1 No
Enumeration date Feb 6th, 2008
Last updated Feb 6th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205014727 NPPES
Illinois Other 0037192 STATE LICENSE NUMBER

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