NPI 1003188913

Evergreen Place Decatur, LLC

Organisation Assisted Living Facility Decatur, IL

Practice location

Address: 4825 E Evergreen Court, Decatur, IL 62521
Phone: (217) 864-4300
Fax: (217) 864-4321
Mailing address: 115 W Jefferson St STE 401, Bloomington, IL 61701-3967

Authorised official

Name: Craig L Ater
Title: Exec Vp & Cfo
Phone: (309) 823-7135

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X

Other Assisted Living Facility providers in Illinois →

Registry record

NPI: 1003188913
Entity type: Organization
NPI issued: 8 Feb 2012
Record last updated: 17 Feb 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.