- Enrollment id
- O20190402002205
- Enrollment state
- IL
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1821561291
- Multiple npi flag
- N
- Ccn
- 145424
- Associate id
- 0547501454
- Organization name
- LANDMARK OF RICHTON PARK REHABILITATION AND NURSING CENTER
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- LANDMARK OF RICHTON PARK REHAB & NSG CTR
- Affiliation entity name
- INFINITY HEALTHCARE CONSULTING
- Affiliation entity id
- 763
- Address line 1
- 22660 CICERO AVE
- City
- RICHTON PARK
- State
- IL
- Zip code
- 604711700