Organization
STONECREST MANOR ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GERI P JOHNSON (ADMINISTRATOR)
(815) 472-2411
Entity
Organization
Contact information
Practice address
110 HARVARD ST, MOMENCE, IL 60954-1757
(815) 472-2411
(815) 472-2051
Mailing address
110 HARVARD ST, MOMENCE, IL 60954-1757
(815) 472-2411
(815) 472-2051
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
5101180
IL
Other
Enumeration date
10/05/2009
Last updated
10/05/2009
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