Organization
ALPHA OMEGA CONSULTING, INC.
Active
Other names
Southside Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELA CORNELL (PRESIDENT)
(217) 422-4725
Entity
Organization
Contact information
Practice address
729 S WEBSTER ST, DECATUR, IL 62521-2672
(217) 422-5478
(217) 422-2143
Mailing address
729 S WEBSTER ST, DECATUR, IL 62521-2672
(217) 422-5478
(217) 422-2143
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0046961
IL
Other
Enumeration date
03/15/2007
Last updated
08/22/2020
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