Cye Sullivan Hco, LLC
Assisted Living Facility in Sullivan, IL. Organization (NPI-2).
NPI number1164055323
StatusActive
Last updated in NPPESFeb 14, 2024
Details
- NPI
- 1164055323
- Entity type
- Organization (NPI-2)
- Legal business name
- Cye Sullivan Hco, LLC
- Organization subpart
- No
- Enumeration date
- Feb 17, 2020
- Certification date
- Feb 14, 2024
- Last updated
- Feb 14, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | – | – | Yes |
Practice location
20 Courtyard BlvdSullivan, IL 61951-7001
Phone 217-728-4300
Mailing address
830 W Trailcreek DrPeoria, IL 61614-1862
Phone 309-689-5880
Authorized official
Mark B. Petersen
Manager
3096918113
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