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WC- HARRISBURG OPS LLC NPI 1538557897


NPI Information

NPI: 1538557897
Provider Name: WC- HARRISBURG OPS, LLC

Doing Business As: BROOKSTONE OF HARRISBURG

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
165 RON MORSE DR
HARRISBURG, IL
ZIP 62946
Phone: (618) 253-5870
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WC- HARRISBURG OPS, LLC is an assisted living facility in Harrisburg, IL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. WC- HARRISBURG OPS, LLC NPI is 1538557897. The provider is registered as an organization entity type.
The provider Is Doing Business As Brookstone Of Harrisburg.

The provider's business location address is:

165 RON MORSE DR
HARRISBURG, IL
ZIP 62946-298
Phone: (618) 253-5870
Fax: (618) 253-5871

The provider's authorized official is Treva Aud .
The authorized official title is Executive Director and has the following contact phone number (618) 253-5870.

The enumeration date for this NPI number is 1/8/2015 and was last updated on 6/28/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living FacilityILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11538557897MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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