Provider Demographics
NPI:1497287577
Name:MAINSTAY, INC,
Entity Type:Organization
Organization Name:MAINSTAY, INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:VAIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-784-8812
Mailing Address - Street 1:1001 GREEN BAY RD
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-1721
Mailing Address - Country:US
Mailing Address - Phone:847-784-8812
Mailing Address - Fax:
Practice Address - Street 1:1001 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-1721
Practice Address - Country:US
Practice Address - Phone:847-784-8812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes132700000XDietary & Nutritional Service ProvidersDietary ManagerGroup - Multi-Specialty