Crystal Lake Memory Care, Llc

NPI 1164795308 - Assisted Living Facility - 310400000X

NPI Details
NPI 1164795308
Enumeration Date 02/20/2012
Last Updated 02/20/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name CHAD CHAD
Position PRESIDENT
Phone (815) 459-7800
Fax (815) 356-3066
Practice Location
495 ALEXANDRA BLVD
CRYSTAL LAKE IL, 60014-8908, US
Phone (815) 459-7800
Fax (815) 356-3066
Business Location
545 E JOHN CARPENTER FWY
SUITE 500
IRVING TX, 75062-3931, US
Phone (214) 845-4500
Fax (214) 845-4501
Toxanomy
Taxonomy Code 310400000X
License State Illinois
License Number 5102865
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According to our database, Crystal Lake Memory Care, Llc NPI is 1164795308, taxonomy code is 310400000X and license number is 5102865, license state is located at Illinois. Crystal Lake Memory Care, Llc physically located at 495 Alexandra Blvd, Crystal Lake IL, 60014-8908. NPI Number 1033115704 has the healthcare provider type.

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1164795308 NPI number is provided on an as is basis without warranty of any kind. 1164795308 is maintained by the National Plan & Provider Enumeration System. The contents of Crystal Lake Memory Care, Llc are for informational purposes only.