Organization
AVONLEA COTTAGE OF QUAD CITIES 2, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL THOMA (MEMBER)
(913) 492-7800
Entity
Organization
Contact information
Practice address
2025 1ST ST E, MILAN, IL 61264-3402
(309) 756-2257
(309) 756-2258
Mailing address
10501 W 84TH TER, LENEXA, KS 66214-1643
(913) 492-7800
(913) 492-7801
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
5100133
IL
310400000X
Assisted Living Facility
Primary
5100141
IL
Other
Enumeration date
06/09/2008
Last updated
01/29/2016
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