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Organization

HICKORY ESTATES OF TAYLORVILLE, LLC

Active
Parent organization
CHRISTIAN COUNTY INTEGRATED COMMUNITY SERVICES
Organization subpart
Yes

Provider details

NPI number
Legal business name
CHRISTIAN COUNTY INTEGRATED COMMUNITY SERVICES
Authorized official
MR. MARCUS PAUL LEACH (MANAGING SUPERVISOR)
(217) 824-3355
Entity
Organization

Contact information

Practice address
1091 E 1500 NORTH RD, TAYLORVILLE, IL 62568-9500
(217) 824-3355
(217) 824-3375
Mailing address
1091 E 1500 NORTH RD, TAYLORVILLE, IL 62568-9500
(217) 824-3355
(217) 824-3375

Taxonomy

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

Other

Enumeration date
09/22/2016
Last updated
09/22/2016
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