Lakewood Senior Living of Mattoon
Organization Active NPI Skilled Nursing Facility · Matton, IL
NPI 1447284245 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1447284245
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0041574 (IL)
- Legal business name
- LAKEWOOD SENIOR LIVING OF MATTOON
- Practice address
- 2121 S 9TH St
Matton, IL 61938 - Phone
- (217) 235-7138
- Fax
- (217) 235-7140
- NPI assigned
- Jul 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Richard J Brockman
- Title
- Ceo
- Phone
- (205) 320-7575
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0041574 | IL | Yes |
Addresses
Primary practice location
2121 S 9TH St
Matton, IL 61938
Mailing address
2121 S 9TH St
Matton, IL 61938
Phone (217) 235-7138
Other names
- Mattoon Health Care & Rehabilitation Center
Other providers in Matton, IL
All providers in Matton, IL · Skilled Nursing Facility in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.