Organization
TIMBERLAKE ESTATES SLF, LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERI D COOPER (MEDICARE BILLING FACILITATOR)
(217) 732-5119
Entity
Organization
Contact information
Practice address
2521 EMPOWERMENT RD, SPRINGFIELD, IL 62703-4983
(217) 321-2100
(217) 321-2130
Mailing address
2521 EMPOWERMENT RD, SPRINGFIELD, IL 62703-4983
(217) 321-2100
(217) 321-2130
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205917599001
—
IL
Enumeration date
09/17/2014
Last updated
06/01/2016
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