Organization
MAS SENIOR LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAIR MINTON (PRESIDENT)
(815) 573-5105
Entity
Organization
Contact information
Practice address
300 LERNA RD S, MATTOON, IL 61938-9389
(217) 234-3003
Mailing address
556 BEACH AVE, BOURBONNAIS, IL 60914-4906
(815) 573-5105
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
0053652
IL
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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