Organization
IMBODEN CREEK LIVING CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BEVERLEY KAY BAITY (MEDICARE BILLER)
(217) 422-7150
Entity
Organization
Contact information
Practice address
180 W IMBODEN DR, DECATUR, IL 62521-5238
(217) 422-7150
(217) 422-9418
Mailing address
180 W IMBODEN DR, DECATUR, IL 62521-5238
(217) 422-7150
(217) 422-9418
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
05/24/2016
Last updated
05/24/2016
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