WC- Vandalia Ops, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

WC- VANDALIA OPS, LLC

Practice address

1607 W Fillmore St
Vandalia, IL 62471-3112

Phone

(618) 283-9825

Fax

(618) 283-9926

NPI assigned

Jan 8, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Shelly Dothager

Title

Executive Director

Phone

(618) 283-9825

Specialties & licenses 1

Addresses

Other names 1

• Brookstone Estates of Vandalia Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420675200000",
    "number": "1053709303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 W FILLMORE ST",
            "city": "VANDALIA",
            "state": "IL",
            "postal_code": "624713112",
            "telephone_number": "618-283-9825",
            "fax_number": "618-283-9926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 W FILLMORE ST",
            "city": "VANDALIA",
            "state": "IL",
            "postal_code": "624713112",
            "telephone_number": "618-283-9825",
            "fax_number": "618-283-9926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WC- VANDALIA OPS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2015-01-08",
        "status": "A",
        "authorized_official_last_name": "DOTHAGER",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-283-9825",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookstone Estates of Vandalia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Vandalia, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.