Provider Demographics
NPI:1588280499
Name:GERIATRIC SR CARE HOME INC
Entity type:Organization
Organization Name:GERIATRIC SR CARE HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ARROJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-983-4332
Mailing Address - Street 1:9933 LAWLER AVE STE 521
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-4301
Mailing Address - Country:US
Mailing Address - Phone:847-983-4332
Mailing Address - Fax:
Practice Address - Street 1:9933 LAWLER AVE STE 521
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-4301
Practice Address - Country:US
Practice Address - Phone:847-983-4332
Practice Address - Fax:847-745-0225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care