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PEKIN SUPPORTIVE LIVING LIMITED PATNERSHIP NPI 1689856312


NPI Information

NPI: 1689856312
Provider Name: PEKIN SUPPORTIVE LIVING LIMITED PATNERSHIP

Doing Business As: JOHN M EVANS SLC

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 14D2196646

Address:
1320 EXECUTIVE COURT
PEKIN, IL
ZIP 61554
Phone: (309) 477-8800
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PEKIN SUPPORTIVE LIVING LIMITED PATNERSHIP is an assisted living facility in Pekin, 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. PEKIN SUPPORTIVE LIVING LIMITED PATNERSHIP NPI is 1689856312. The provider is registered as an organization entity type.
The provider Is Doing Business As John M Evans Slc.

The provider's business location address is:

1320 EXECUTIVE COURT
PEKIN, IL
ZIP 61554
Phone: (309) 477-8800
Fax: (309) 477-8801

The provider's authorized official is Melanie S. Daniels .
The authorized official title is Administrator and has the following contact phone number (309) 477-8800.

The CLIA number assigned to this NPI record is 14D2196646 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/5/2007 and was last updated on 12/5/2007.


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 FacilityYes

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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