Healthcare Provider Details

I. General information

NPI: 1871646133
Provider Name (Legal Business Name): PARIS HEALTH CARE CENTER INVESTORS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 10/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 N. MAIN STREET
PARIS IL
61944-1145
US

IV. Provider business mailing address

1011 N. MAIN STREET
PARIS IL
61944-1145
US

V. Phone/Fax

Practice location:
  • Phone: 217-465-5376
  • Fax: 217-465-8106
Mailing address:
  • Phone: 217-465-5376
  • Fax: 217-465-8106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0046565
License Number StateIL

VIII. Authorized Official

Name: MRS. CYNTHIA RENE ROTH
Title or Position: CONTROLLER
Credential:
Phone: 317-557-1190