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Organization

11755 N MICHIGAN TENANT LLC

Active
Other names
Grand Victorian of Zionsville
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GREG ECHOLS (CO-PRESIDENT OF ITS MANAGEMENT AGEN)
(779) 216-5849
Entity
Organization

Contact information

Practice address
11755 N MICHIGAN RD, ZIONSVILLE, IN 46077-9325
(317) 873-6300
Mailing address
200 E COURT ST STE 400, KANKAKEE, IL 60901-3848
(815) 935-1992
(815) 935-8380

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
10/25/2024
Last updated
10/25/2024
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