Midwest Care Mattoon North LLC
Point of Service in Mattoon, IL. Organization (NPI-2).
NPI number1366776296
StatusActive
Last updated in NPPESSep 24, 2009
Details
- NPI
- 1366776296
- Entity type
- Organization (NPI-2)
- Legal business name
- Midwest Care Mattoon North LLC
- Organization subpart
- No
- Enumeration date
- Sep 24, 2009
- Last updated
- Sep 24, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 305S00000X | Point of Service | – | – | Yes |
Practice location
1920 Brookstone LnMattoon, IL 61938-6105
Phone 217-235-5881
Mailing address
78 Centennial LoopEugene, OR 97401-7900
Authorized official
Howard Kang
Vp Of Accounting And Finance
5417473373
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