Organization
EVERGREEN STREATOR, L.P.
Active
Other names
Evergreen Place of Streator Supportive Living
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG L. ATER (SENIOR V.P. OF FINANCE)
(309) 828-4361
Entity
Organization
Contact information
Practice address
1529 E MAIN ST, STREATOR, IL 61364-3162
(815) 672-0903
(815) 672-0639
Mailing address
115 W JEFFERSON ST, STE 401, PO BOX 3188, BLOOMINGTON, IL 61701-3946
(309) 823-7155
(309) 829-9512
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/24/2008
Last updated
11/24/2008
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