BLC - Park Place, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

BH 1759 Issued in WA

Legal business name

BLC - PARK PLACE, LLC

Practice address

330 N Wabash Ave
Suite 1400
Chicago, IL 60611-3586

Phone

(312) 977-3700

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

Mark J. Schulte

Title

Ceo

Phone

(312) 977-3700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Park Place Doing business as

Tax ID family

BLC - Park Place LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• BLC-Park Place, LLC

  • Assisted Living Facility
  • Spokane Valley, WA
  • NPI 1285055806
  NPD tax ID

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679633192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S PARK RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992120593",
            "telephone_number": "509-922-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N WABASH AVE",
            "address_2": "SUITE 1400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113586",
            "telephone_number": "312-977-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLC - PARK PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHULTE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-977-3700"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WA",
            "license": "BH 1759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "652398",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gabrielle Blazek
• Rachel Blazek, PT
• Melisa Blazevic
• Mary Blazevich, PT
• Matthew Francis Blazo, PA-C
• BLC-Kenwood of Lake View, LLC
• BLC-the Hallmark, LLC
• Thomas P Bleck, MD
• Courtney Bledsoe, L.C.S.W.
• Jeanette Nadene Bledsoe

• Assisted Living Facility in Chicago, IL
• Providers in Chicago, 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.