- Enrollment id
- O20120511000229
- Enrollment state
- IL
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1245526854
- Multiple npi flag
- N
- Ccn
- 145752
- Associate id
- 9133382039
- Organization name
- FOREST VIEW REHABILITATION AND NURSING CENTER
- Incorporation date
- 2011-05-19
- Incorporation state
- IL
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- LANDMARK OF ITASCA REHABILITATION AND NURSING CENTER LLC
- Affiliation entity name
- INFINITY HEALTHCARE CONSULTING
- Affiliation entity id
- 763
- Address line 1
- 535 S ELM ST
- City
- ITASCA
- State
- IL
- Zip code
- 601432187