MEDICARE: ALEISHA DELONG CNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1851120380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEISHA DELONG CNA

Provider Business Mailing Address
First Line	:	1330 N CHERRY ST
Second Line	:
City	:	MOUNT CARMEL
State	:	IL
Zip	:	62863-1857
Country	:	US
Telephone Number	:	618-240-9188
Fax Number	:

Provider Business Practice Location Address
First Line	:	1330 N CHERRY ST
Second Line	:
City	:	MOUNT CARMEL
State	:	IL
Zip	:	62863-1857
Country	:	US
Telephone Number	:	618-240-9188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2024
Last Update Date	:	08/01/2024

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