# FOREVER STRONG

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457758278
- **Authorized official:** SAMANTHA J MOORE (OWNER/NURSE)
- **Authorized official phone:** (217) 778-9908

## Contact information

- **Practice address:** 1014 S DUNCAN RD, CHAMPAIGN, IL 61821-4040
- **Practice address phone:** (217) 778-9908
- **Mailing address:** 1014 S DUNCAN RD, CHAMPAIGN, IL 61821-4040
- **Mailing address phone:** (217) 778-9908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 251E0000X | IL | Yes |

## Other

- **Enumeration date:** 11/21/2014
- **Last updated:** 11/21/2014