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Organization

EVERGREEN PLACE DECATUR, LLC

Active
Other names
Evergreen Place Decatur Supportive Living
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CRAIG L ATER (EXEC VP & CFO)
(309) 823-7135
Entity
Organization

Contact information

Practice address
4825 E EVERGREEN COURT, DECATUR, IL 62521
(217) 864-4300
(217) 864-4321
Mailing address
115 W JEFFERSON ST STE 401, BLOOMINGTON, IL 61701-3967
(309) 823-7155
(309) 829-9512

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
IL

Other

Enumeration date
02/08/2012
Last updated
02/17/2012
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