Rose Angela Hall

LBN: St. Mary Of Providence
Rose Angela Hall is an health care organization with primary practice located at 4200 N Austin Ave , Chicago IL 60634-1615. 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. St. Mary Of Providence can be contacted via phone (773) 545-8300, or through Butler, Rita M via phone (773) 545-8300.

Contact Information

Primary practice address
4200 N Austin Ave Chicago IL 60634-1615
Phone: (773) 545-8300
Fax: (773) 545-2984
Website:
Map and Directions
Authorized official contact:
Name: Butler, Rita M R.N., NHA
Phone: (773) 545-8300

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 0033761 Illinois

Profile Details

NPI number 1588842470
LBN Legal business name St. Mary Of Providence
DBA Doing business as Rose Angela Hall
Authorized official Butler, Rita M R.N., NHA
Entity Organization
Organization subpart 1 Yes
Enumeration date Feb 4th, 2008
Last updated Feb 4th, 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 1588842470 NPPES
Illinois MEDICAID 14G191

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