SPRINGFIELD SUPPORTIVE LIVING NPI 1821129974

NPI Information

  • NPI: 1821129974
  • Provider Name: SPRINGFIELD SUPPORTIVE LIVING
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Address: 2034 E CLEAR LAKE AVE
    SPRINGFIELD, IL
    ZIP 62703
  • Phone: (217) 522-8843

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NPI Details

SPRINGFIELD SUPPORTIVE LIVING is an assisted living facility in Springfield, 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. SPRINGFIELD SUPPORTIVE LIVING NPI is 1821129974. The provider is registered as an organization entity type.

The provider's business location address is:

2034 E CLEAR LAKE AVE
SPRINGFIELD, IL
ZIP 62703-134
Phone: (217) 522-8843
Fax: (217) 522-8803

The provider's authorized official is Mark Roeckell .
The authorized official title is Member and has the following contact phone number (847) 229-3400.

The enumeration date for this NPI number is 3/8/2007 and was last updated on 8/22/2020.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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: 3/30/2025

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