BOHEMIAN HOME FOR THE AGED NPI 1083819726

NPI Information

NPI: 1083819726
Provider Name: BOHEMIAN HOME FOR THE AGED

Doing Business As: TABOR HILLS SUPPORTIVE COMMUNITY LLC

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

Address:
1347 CRYSTAL AVE
NAPERVILLE, IL
ZIP 60563
Phone: (630) 778-6677
Get Directions

BOHEMIAN HOME FOR THE AGED is an assisted living facility in Naperville, IL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. BOHEMIAN HOME FOR THE AGED NPI is 1083819726. The provider is registered as an organization entity type.
The provider Is Doing Business As Tabor Hills Supportive Community Llc.

The provider's business location address is:

1347 CRYSTAL AVE
NAPERVILLE, IL
ZIP 60563-149
Phone: (630) 778-6677
Fax: (630) 778-6680

The provider's authorized official is Frances Salinas .
The authorized official title is Chief Financial Officer and has the following contact phone number (630) 778-6677.

The CLIA number assigned to this NPI record is 14D0891030 - skilled nursing/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/20/2007 and was last updated on 8/4/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========002	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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