- Enrollment id
- O20240102001415
- Enrollment state
- IL
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1437856739
- Multiple npi flag
- N
- Ccn
- 146149
- Associate id
- 9739539875
- Organization name
- WESTWOOD VILLAGE NURSING AND REHABILITATION CENTER, LLC
- Doing business as name
- WESTWOOD VILLAGE NURSING AND REHAB
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- WESTWOOD VLGE NRSG AND RHB CTR
- Affiliation entity name
- WISSATI IRREVOCABLE TRUST
- Affiliation entity id
- 861
- Address line 1
- 2444 W TOUHY AVE
- City
- CHICAGO
- State
- IL
- Zip code
- 606453310