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General NPI Number Information
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NPI Number | 1265616536
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Entity Type | Organization
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Legal Business Name | WASHINGTON VILLAGE ESTATES, LP
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1150 NEWCASTLE RD
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City | WASHINGTON
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State | IL
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Zip | 61571-1244
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Country | US
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Telephone | 309-444-3641
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Fax | 309-444-8763
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Provider Business Mailing Address
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Address Line | 1150 NEWCASTLE RD
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City | WASHINGTON
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State | IL
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Zip | 61571-1244
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Country | US
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Telephone | 309-444-3641
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Fax | 309-444-8763
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Authorized Official
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Title or Position | CONTROLLER
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Name | MRS. SUSAN MCGHEE
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Credential |
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Telephone | 217-732-5175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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