Organization · Type 2 NPI
Crystal Lake Memory Care, LLC
Assisted Living Facility · Crystal Lake, IL
NPI number
1164795308
Active
Practice location
495 Alexandra Blvd
Crystal Lake, IL 60014-8908
Fax (815) 356-3066
Mailing address
545 E John Carpenter Fwy, Suite 500
Irving, TX 75062-3931
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Assisted Living Facility Primary | 310400000X | 5102865 (IL) |
Assisted Living Facility: 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.
About NPI 1164795308
Crystal Lake Memory Care, LLC's National Provider Identifier is 1164795308, issued on Feb 20, 2012. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Crystal Lake, IL. The record was last updated on Feb 20, 2012.