Organization
MANTENO SPRINGS ASSISTED LIVING
Active
Other names
None
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GERI P. JOHNSON (ADMINISTRATOR)
(815) 468-6896
Entity
Organization
Contact information
Practice address
600 N BIRCH ST, MANTENO, IL 60950-1391
(815) 468-6896
Mailing address
600 N BIRCH ST, MANTENO, IL 60950-1391
(815) 468-6896
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
5100943
IL
Other
Enumeration date
10/05/2009
Last updated
10/05/2009
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