Healthcare Provider Details
I. General information
NPI: 1932763992
Provider Name (Legal Business Name): ALLURE OF GENESEO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/25/2019
Last Update Date: 12/03/2021
Certification Date: 12/03/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
704 S ILLINOIS ST
GENESEO IL
61254-1782
US
IV. Provider business mailing address
2711 W HOWARD ST
CHICAGO IL
60645-1303
US
V. Phone/Fax
- Phone: 309-944-6424
- Fax:
- Phone: 773-338-4400
- Fax: 773-338-4414
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SAMANTHA
MEYER
Title or Position: VP OF REVENUE CYCLE MANAGEMENT
Credential:
Phone: 733-338-4400