Basic Information
| Provider Information | |||||||||
| NPI: | 1487824702 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | JOSHUA ARMS OF LUTHERAN SOCIAL SERVICES OF ILLINOIS | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | JOSHUA ARMS OF LUTHERAN SOCIAL SERVICES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 E TOUHY AVE | ||||||||
| Address2: | |||||||||
| City: | DES PLAINES | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600185801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8473901411 | ||||||||
| FaxNumber: | 8473901426 | ||||||||
| Practice Location | |||||||||
| Address1: | 1315 ROWELL AVE | ||||||||
| Address2: | |||||||||
| City: | JOLIET | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604332849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157276401 | ||||||||
| FaxNumber: | 8157276477 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2008 | ||||||||
| LastUpdateDate: | 08/19/2016 | ||||||||
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| AuthorizedOfficialLastName: | NATHANIEL | ||||||||
| AuthorizedOfficialFirstName: | VAYA | ||||||||
| AuthorizedOfficialMiddleName: | C. | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF PROPERTY MANAGEMENT | ||||||||
| AuthorizedOfficialTelephone: | 8473901411 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251V00000X | N | Agencies | Voluntary or Charitable | 310400000X | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.