Organization
PHILLIPS WARNER REALTY, LLC - MONTICELLO OPERATION SERIES
Active
Parent organization
PHILLIPS WARNER REALTY, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHILLIPS WARNER REALTY, LLC
Authorized official
RANDY PORTER CFO (CHIEF FINANCIAL OFFICER)
(217) 345-5022
Entity
Organization
Contact information
Practice address
901 MEDICAL CENTER DR, MONTICELLO, IL 61856-2144
(217) 631-1136
Mailing address
2402 18TH ST, CHARLESTON, IL 61920-4343
(217) 345-5022
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/05/2024
Last updated
10/07/2024
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