NPI 1518163187

Mattoon Estates South, LLC

Organisation Point of Service Mattoon, IL

Practice location

Address: 2008 S 9th St, Mattoon, IL 61938-6164
Phone: (217) 235-5871
Fax: (217) 235-5899
Mailing address: 78 Centennial Loop, Eugene, OR 97401-7900

Authorised official

Name: John Holtz
Title: Controller
Phone: (541) 747-3373

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X

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Registry record

NPI: 1518163187
Entity type: Organization
NPI issued: 21 Jun 2007
Record last updated: 14 May 2008

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.