Organization
SPRINGFIELD ELDER CARE, LLC
Active
Organization
SPRINGFIELD ELDER CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELIZABETH DIANNE CARLSON PH.D, MPH, BSN (OWNER)
(217) 741-4304
Entity
Organization
Contact information
Practice address
1808 S BATES AVE, SPRINGFIELD, IL 62704-3354
(217) 741-4304
Mailing address
1808 S BATES AVE, SPRINGFIELD, IL 62704-3354
(217) 741-4304
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
209006847
IL
Other
Enumeration date
08/24/2010
Last updated
08/24/2010
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