PRAIRIE VILLAGE SUPPORTIVE LIVING LLC; NPI #1518339167

Contact Information

PRAIRIE VILLAGE SUPPORTIVE LIVING LLC

200 INTERNATIONAL DRIVE
RANTOUL, IL 61866

Phone: 217-892-2800
Fax: 217-892-2833
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Assisted Living Facility	310400000X
Alzheimer Center /Dementia Center/Dementia Special Care Unit	311500000X

Indicates primary specialty

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NPI Profile & details for PRAIRIE VILLAGE SUPPORTIVE LIVING LLC

NPI #	`1518339167`
LBN Legal business name	PRAIRIE VILLAGE SUPPORTIVE LIVING LLC
Authorized official	JOELLEN BLEAVINS - (VICE PRESIDENT OF MANAGEMENT AGENT)
Entity	Organization
Organization subpart ¹	Yes
Enumeration date	10/22/2015
Last updated	11/03/2015 - About 11 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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PRAIRIE VILLAGE SUPPORTIVE LIVING LLC

Contact Information

Specialty

Assisted Living Facility

Alzheimer Center /Dementia Center/Dementia Special Care Unit

NPI Profile & details for PRAIRIE VILLAGE SUPPORTIVE LIVING LLC

Reviews for PRAIRIE VILLAGE SUPPORTIVE LIVING LLC