Provider Demographics
NPI:1801047832
Name:LIVING SPRINGS OF MCHENRY
Entity type:Organization
Organization Name:LIVING SPRINGS OF MCHENRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOXX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-344-2690
Mailing Address - Street 1:4609 W CRYSTAL LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-5424
Mailing Address - Country:US
Mailing Address - Phone:815-344-2690
Mailing Address - Fax:815-344-2691
Practice Address - Street 1:4609 W CRYSTAL LAKE RD
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-5424
Practice Address - Country:US
Practice Address - Phone:815-344-2690
Practice Address - Fax:815-344-2691
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BMA PROPERTIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility