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MCLEAN COUNTY ASSISTED LIVING FACILITY L.L.C. NPI 1447429378


NPI Information

NPI: 1447429378
Provider Name: MCLEAN COUNTY ASSISTED LIVING FACILITY, L.L.C.

Doing Business As: EVERGREEN PLACE ASSISTED LIVING FACILITY

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

CLIA Number: 14D2194770

Address:
801 GREGORY ST
NORMAL, IL
ZIP 61761
Phone: (309) 451-9355
Get Directions

MCLEAN COUNTY ASSISTED LIVING FACILITY, L.L.C. is an assisted living facility in Normal, 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. MCLEAN COUNTY ASSISTED LIVING FACILITY, L.L.C. NPI is 1447429378. The provider is registered as an organization entity type.
The provider Is Doing Business As Evergreen Place Assisted Living Facility.

The provider's business location address is:

801 GREGORY ST
NORMAL, IL
ZIP 61761-431
Phone: (309) 451-9355
Fax: (309) 862-4329

The provider's authorized official is Craig L. Ater .
The authorized official title is Senior V.p. Of Finance and has the following contact phone number (309) 823-7135.

The CLIA number assigned to this NPI record is 14D2194770 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/25/2008 and was last updated on 2/25/2008.


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
1310400000XAssisted Living Facility1821581ILLINOISYes

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.