- Enrollment id
- O20070507000005
- Enrollment state
- IL
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1487641064
- Multiple npi flag
- N
- Ccn
- 145739
- Associate id
- 0446229876
- Organization name
- LUTHERAN HOME FOR THE AGED
- Doing business as name
- THOMAS CUISINE
- Incorporation date
- 1892-08-09
- Incorporation state
- IL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Nursing home provider name
- LUTHERAN HOME FOR THE AGED
- Address line 1
- 800W OAKTON ST
- City
- ARLINGTON HEIGHTS
- State
- IL
- Zip code
- 600044602