Organization
MCLEAN COUNTY ASSISTED LIVING, L.L.C.
Active
Parent organization
MCLEAN COUNTY ASSISTED LIVING, L.L.C.
Other names
Evergreen Village Supportive Living, L.L.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MCLEAN COUNTY ASSISTED LIVING, L.L.C.
Authorized official
MR. CRAIG L. ATER (SENIOR V. P. OF FINANCE)
(309) 823-7135
Entity
Organization
Contact information
Practice address
1701 EVERGREEN VILLAGE BLVD, NORMAL, IL 61761
(309) 452-7300
(309) 452-7311
Mailing address
115 W JEFFERSON ST, SUITE 401, PO BOX 3188, BLOOMINGTON, IL 61701-3946
(309) 823-7155
(309) 829-9512
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205051684001
—
IL
Enumeration date
02/27/2008
Last updated
08/06/2008
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