Organization · Type 2 NPI

McLean County Assisted Living, L.l.c.

Assisted Living Facility · Normal, IL

NPI number 1629247283 Active

Practice location

1701 Evergreen Village Blvd
Normal, IL 61761

Call (309) 452-7300 Map

Fax (309) 452-7311

Mailing address

115 W Jefferson St, Suite 401, PO Box 3188
Bloomington, IL 61701-3946

Specialties and licenses

Taxonomy	Code	License
Assisted Living Facility Primary	310400000X	None listed

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.

Other assisted living facility providers in Normal

See all in Normal →

NPI record

NPI: 1629247283
Entity type: Organization (Type 2)
Issued: Feb 27, 2008
Last updated: Aug 6, 2008
Status: Active
Subpart: Yes of McLean County Assisted Living, L.l.c.

Other names

<unavail>
Evergreen Village Supportive Living, L.l.c. · doing business as

Authorized official

Mr. Craig L. Ater
Senior V. P. of Finance
(309) 823-7135

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1629247283

McLean County Assisted Living, L.l.c.'s National Provider Identifier is 1629247283, issued on Feb 27, 2008. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Normal, IL. The record was last updated on Aug 6, 2008.