Provider Demographics
NPI:1174821623
Name:ST FRANCIS WOODS LLC
Entity Type:Organization
Organization Name:ST FRANCIS WOODS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:SCHLEICHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-314-7522
Mailing Address - Street 1:3507 N MOLLECK DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61604-1013
Mailing Address - Country:US
Mailing Address - Phone:309-688-0093
Mailing Address - Fax:309-687-3550
Practice Address - Street 1:400 W MIDLAND AVE
Practice Address - Street 2:POB. 5430
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-3144
Practice Address - Country:US
Practice Address - Phone:719-686-8140
Practice Address - Fax:719-686-8141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility