Emerald Glen Management

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EMERALD GLEN MANAGEMENT

Practice address

18192 Renken Road
Staunton, IL 62088

Phone

(618) 635-4012

NPI assigned

Sep 24, 2007

Organization subpart

No

Name

Shelley C Nuelle

Title

Director of Operations

Phone

(217) 821-9539

Tax ID family

Emerald Glen Management2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Emerald Glen Managment

  • Assisted Living Facility
  • Greenville, IL
  • NPI 1093900425
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 24, 2007.

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190592000000",
    "number": "1104012129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 771",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "62401",
            "telephone_number": "217-821-9539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18192 RENKEN ROAD",
            "city": "STAUNTON",
            "state": "IL",
            "postal_code": "62088",
            "telephone_number": "618-635-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD GLEN MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2007-09-24",
        "status": "A",
        "authorized_official_last_name": "NUELLE",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "217-821-9539"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Staunton, IL
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; 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.