Charleston Estates, LLC
NPI #1407052079 in Charleston, Illinois
Provider Information
- NPI Number
- 1407052079
- Entity Type
- Organization
- Organization Name
- Charleston Estates, LLC
- Primary Specialty
- Point of Service
- Enumeration Date
- Jun 21, 2007
- Last Updated
- May 14, 2008
Practice Location
- Address
- 300 LINCOLN HIGHWAY RD
- City
- Charleston
- State
- Illinois
- ZIP Code
- 61920-3884
- Phone
- (217) 348-6500
Authorized Official
- Name
- MR. JOHN HOLTZ
- Title
- CONTROLLER
- Phone
- (541) 747-3373
Specialties & Taxonomy Codes
| Specialty |
|---|
| Point of Service |
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