Organization
CRYSTAL LAKE MEMORY CARE, LLC
Active
Other names
Autumn Leaves of Crystal Lake
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHAD ANDERSON (PRESIDENT)
(214) 845-4500
Entity
Organization
Contact information
Practice address
495 ALEXANDRA BLVD, CRYSTAL LAKE, IL 60014-8908
(815) 459-7800
(815) 356-3066
Mailing address
545 E JOHN CARPENTER FWY, SUITE 500, IRVING, TX 75062-3931
(214) 845-4500
(214) 845-4501
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
5102865
IL
Other
Enumeration date
02/20/2012
Last updated
02/20/2012
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