Provider Demographics
NPI:1356008775
Name:MCA SENIOR HOUSING AND COMMUNITY SERVICES, LLC
Entity Type:Organization
Organization Name:MCA SENIOR HOUSING AND COMMUNITY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KLEINERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:779-701-7764
Mailing Address - Street 1:315 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:CHEBANSE
Mailing Address - State:IL
Mailing Address - Zip Code:60922-8038
Mailing Address - Country:US
Mailing Address - Phone:779-701-7764
Mailing Address - Fax:
Practice Address - Street 1:315 PEACH ST
Practice Address - Street 2:
Practice Address - City:CHEBANSE
Practice Address - State:IL
Practice Address - Zip Code:60922-8038
Practice Address - Country:US
Practice Address - Phone:779-701-7764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No332U00000XSuppliersHome Delivered Meals
No347C00000XTransportation ServicesPrivate Vehicle