Rockford Supportive Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ROCKFORD SUPPORTIVE LIVING

Practice address

2114 Kishwaukee St
Rockford, IL 61104-7099

Phone

(815) 966-1030

Fax

(815) 966-1090

NPI assigned

Mar 8, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Patrick Finn

Title

Member

Phone

(847) 229-3400

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609907740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 MIDLOTHIAN TPKE",
            "address_2": "SUITE 20",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604454900",
            "telephone_number": "708-371-4507",
            "fax_number": "708-371-1761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 KISHWAUKEE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611047099",
            "telephone_number": "815-966-1030",
            "fax_number": "815-966-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKFORD SUPPORTIVE LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FINN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "847-229-3400"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Rockford, IL
• Providers in Rockford, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.