Gahcr II Mt. Zion Alf TRS Sub, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GAHCR II MT. ZION ALF TRS SUB, LLC

Doing business as

Glenwood of Mount Zion

Practice address

1635 N Baltimore Ave
Mount Zion, IL 62549-1086

Phone

(217) 864-1073

Fax

(217) 864-1077

NPI assigned

Jun 5, 2014

Organization subpart

No

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

Authorized official

Name

Danny Prosky

Title

President

Phone

(949) 270-9200

Specialties & licenses 1

Addresses

Other names 1

• GLENWOOD OF MOUNT ZION Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402358400000",
    "number": "1417360512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 N BALTIMORE AVE",
            "city": "MOUNT ZION",
            "state": "IL",
            "postal_code": "625491086",
            "telephone_number": "217-864-1073",
            "fax_number": "217-864-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 N BALTIMORE AVE",
            "city": "MOUNT ZION",
            "state": "IL",
            "postal_code": "625491086",
            "telephone_number": "217-864-1073",
            "fax_number": "217-864-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAHCR II MT. ZION ALF TRS SUB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-05",
        "last_updated": "2014-06-10",
        "status": "A",
        "authorized_official_last_name": "PROSKY",
        "authorized_official_first_name": "DANNY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-270-9200"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLENWOOD OF MOUNT ZION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Courtney Doty, PTA
• Amy Fink, PTA
• Dustin Joseph Fink, MS, ATC
• Nicole E. Floyd
• Meghan Fritzsche, MS, BCBA
• Gently Nourish Nutrition Therapy LLC
• Greenwell Family Chiropractic LLC
• Eve Marie Greenwell, DC
• Allison Hammer
• Brian Jeffrey Healy, OTR/L

• Assisted Living Facility in Mt Zion, IL
• Providers in Mt Zion, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.