Healthcare Provider Details

I. General information

NPI: 1689062945
Provider Name (Legal Business Name): WC- PARIS OPS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2015
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 BROOKSTONE EST
PARIS IL
61944-9603
US

IV. Provider business mailing address

146 BROOKSTONE EST
PARIS IL
61944-9603
US

V. Phone/Fax

Practice location:
  • Phone: 217-463-5871
  • Fax: 217-463-5875
Mailing address:
  • Phone: 217-463-5871
  • Fax: 217-463-5875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateIL

VIII. Authorized Official

Name: MS. ADA RIGDON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 217-463-5871