The Mary Bryant Home Association

NPI 1255530945 - Assisted Living Facility - 310400000X

NPI Details
NPI 1255530945
Enumeration Date 07/13/2007
Last Updated 07/13/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name JEROME PATRICK JEROME
Position EXECUTIVE DIRECTOR
Phone (217) 529-1611
Fax (217) 529-6975
Practice Location
2960 STANTON ST.
SPRINGFIELD IL, 62703-4385, US
Phone (217) 529-1611
Fax (217) 529-6975
Business Location
2960 STANTON ST
SPRINGFIELD IL, 62703-4315, US
Phone (217) 529-1611
Fax (217) 529-6975
Toxanomy
Taxonomy Code 310400000X
License State
License Number
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According to our database, The Mary Bryant Home Association NPI is 1255530945, taxonomy code is 310400000X The Mary Bryant Home Association physically located at 2960 Stanton St., Springfield IL, 62703-4385. NPI Number 1033115704 has the healthcare provider type.

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1255530945 NPI number is provided on an as is basis without warranty of any kind. 1255530945 is maintained by the National Plan & Provider Enumeration System. The contents of The Mary Bryant Home Association are for informational purposes only.