Provider Demographics
NPI: | 1053627448 |
---|---|
Name: | SPRINGFIELD CARE CENTER, LLC |
Entity Type: | Organization |
Organization Name: | SPRINGFIELD CARE CENTER, LLC |
Other - Org Name: | APERION CARE SPRINGFIELD |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | MANAGER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | YOSEF |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MEYSTEL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 847-673-6767 |
Mailing Address - Street 1: | 8131 MONTICELLO AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | SKOKIE |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60076-3325 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 847-673-6767 |
Mailing Address - Fax: | 847-673-6768 |
Practice Address - Street 1: | 525 S MARTIN LUTHER KING JR DR |
Practice Address - Street 2: | |
Practice Address - City: | SPRINGFIELD |
Practice Address - State: | IL |
Practice Address - Zip Code: | 62703-1317 |
Practice Address - Country: | US |
Practice Address - Phone: | 217-789-1680 |
Practice Address - Fax: | 217-789-0842 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-08-24 |
Last Update Date: | 2014-08-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 313M00000X | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility |