Pavilion On Main Street Llc

LBN: Pavilion On Main Street Llc
Pavilion On Main Street Llc is an health care organization with primary practice located at 515 N Main St , Sandwich IL 60548-1253. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Pavilion On Main Street Llc can be contacted via phone (815) 786-8426, or through Graf, Marcella via phone (224) 470-2044.

Contact Information

Primary practice address
515 N Main St Sandwich IL 60548-1253
Phone: (815) 786-8426
Fax: (815) 786-6487
Website:
Map and Directions
Authorized official contact:
Name: Graf, Marcella
Phone: (224) 470-2044

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X

Profile Details

NPI number 1366180903
LBN Legal business name Pavilion On Main Street Llc
DBA Doing business as
Authorized official Graf, Marcella
Entity Organization
Organization subpart 1 No
Enumeration date May 24th, 2022
Last updated May 24th, 2022 - about 4 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 1366180903 NPPES
Illinois MEDICAID 6008379

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