Organization
WC- VANDALIA OPS, LLC
Active
Other names
Brookstone Estates of Vandalia
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHELLY DOTHAGER (EXECUTIVE DIRECTOR)
(618) 283-9825
Entity
Organization
Contact information
Practice address
1607 W FILLMORE ST, VANDALIA, IL 62471-3112
(618) 283-9825
(618) 283-9926
Mailing address
1607 W FILLMORE ST, VANDALIA, IL 62471-3112
(618) 283-9825
(618) 283-9926
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
IL
Other
Enumeration date
01/08/2015
Last updated
01/08/2015
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