NPI 1205488954

Laureate Kankakee Operations LLC

Organisation Mental Illness Intermediate Care Facility Bourbonnais, IL

Practice location

Address: 100 Belle Aire Ave, Bourbonnais, IL 60914-2006
Phone: (815) 939-0910
Fax: (815) 929-0973
Mailing address: 13024 Balntyn Corp Pl STE 425, Charlotte, NC 28277-4420

Authorised official

Name: Shaun Ahmad
Title: Manager
Phone: (704) 426-8849

Registered specialties

Mental Illness Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310500000X

Other Intermediate Care Facility, Mental Illness providers in Illinois →

Registry record

NPI: 1205488954
Entity type: Organization
NPI issued: 12 Jul 2019
Record last updated: 12 Jul 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.