Prairie Village Supportive Living LLC
NPI #1518339167 in Rantoul, Illinois
Provider Information
- NPI Number
- 1518339167
- Entity Type
- Organization
- Organization Name
- Prairie Village Supportive Living LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- PRAIRIE VILLAGE SUPPORTIVE LIVING LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Oct 22, 2015
- Last Updated
- Nov 3, 2015
Practice Location
Authorized Official
- Name
- JOELLEN BLEAVINS
- Title
- VICE PRESIDENT OF MANAGEMENT AGENT
- Phone
- (815) 935-1992
Specialties & Taxonomy Codes
| Specialty |
|---|
| Alzheimer Center (Dementia Center) |
| Assisted Living Facility |
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