Gurnee Supportive Living, LP

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GURNEE SUPPORTIVE LIVING, LP

Practice address

3775 Grand Ave
Gurnee, IL 60031-2910

Phone

(847) 623-6300

Fax

(847) 623-6305

NPI assigned

Oct 30, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Keri Horn

Title

Regional Director of Operations

Phone

(847) 623-6300

Specialties & licenses 1

Addresses

Other names 1

• Heritage Woods of Gurnee Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1669726527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3775 GRAND AVE",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600312910",
            "telephone_number": "847-623-6300",
            "fax_number": "847-623-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 GRAND AVE",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600312910",
            "telephone_number": "847-623-6300",
            "fax_number": "847-623-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GURNEE SUPPORTIVE LIVING, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "HORN",
        "authorized_official_first_name": "KERI",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "847-623-6300",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Woods of Gurnee",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gurnee Physical Medicine LTD
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• Gurnee School District 56
• Gurnee Stone Medical Center P.C
• Gurnee Stone Medical Center PC
• Gurnee Surgicare LLC
• Gurneectd LLC
• Deborah A. Gust, M.A.
• Alma Guzman, MD
• Ashley Hafertepe, APN

• Assisted Living Facility in Gurnee, IL
• Providers in Gurnee, 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 Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.