PRAIRIE VILLAGE SUPPORTIVE LIVING LLC - NPI 1518339167 - Assisted Living Facility in Rantoul, IL

Q: What is Prairie Village Supportive Living LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

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About Prairie Village Supportive Living Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRAIRIE VILLAGE SUPPORTIVE LIVING LLC (NPI 1518339167) is a healthcare organization registered as an assisted living facility in Rantoul, Illinois and active in the NPI registry since October 2015. The organization lists Joellen Bleavins, Vice President Of Management Agent, as its authorized official.

NPPES Registry Identity

NPI1518339167

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NamePRAIRIE VILLAGE SUPPORTIVE LIVING LLC

Location Address200 INTERNATIONAL DRIVERantoul, IL 61866

Mailing Address200 International DriveRantoul, IL 61866 · (217) 892-2800 · Fax (217) 892-2833

Phone(217) 892-2800

Fax(217) 892-2833

Organization SubpartYes

Authorized OfficialJoellen BleavinsVice President Of Management Agent · (815) 935-1992

Enumeration DateOctober 22, 2015

Last NPPES UpdateNovember 3, 2015

✔ NPI 1518339167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

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.

Also ListedAlzheimer Center (Dementia Center)Taxonomy 311500000X

200 INTERNATIONAL DRIVE, Rantoul, IL 61866

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PREFERRED CARE LLC

Assisted Living Facility

200 INTERNATIONAL DRIVE
RANTOUL, IL 61866

Champaign County (217) 892-2800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prairie Village Supportive Living LLC's NPI number?

The NPI number for Prairie Village Supportive Living LLC is 1518339167. It was assigned to this organization in the NPPES registry on October 22, 2015.

Where is Prairie Village Supportive Living LLC located?

Prairie Village Supportive Living LLC is located at 200 International Drive, Rantoul, IL 61866. The listed phone number is (217) 892-2800.

What is Prairie Village Supportive Living LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Prairie Village Supportive Living LLC was last updated on November 3, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.