Organization
GAHCR II MAHOMET ALF TRS SUB, LLC
Active
Other names
The Glenwood of Mahomet
Organization subpart
No
Provider details
NPI number
Authorized official
DANNY PROSKY (PRESIDENT)
(949) 270-9200
Entity
Organization
Contact information
Practice address
1709 S DIVISION ST, MAHOMET, IL 61853-3747
(217) 586-5100
(217) 586-5151
Mailing address
1709 S DIVISION ST, MAHOMET, IL 61853-3747
(217) 586-5100
(217) 586-5151
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
03/26/2015
Last updated
03/26/2015
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