Mas Senior Living, LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

0053652 Issued in IL

Legal business name

MAS SENIOR LIVING, LLC

Practice address

300 Lerna Rd S
Mattoon, IL 61938-9389

Phone

(217) 234-3003

NPI assigned

May 2, 2016

Organization subpart

No

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

Authorized official

Name

Blair Minton

Title

President

Phone

(815) 573-5105

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462147200000",
    "number": "1609221217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 BEACH AVE",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609144906",
            "telephone_number": "815-573-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LERNA RD S",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619389389",
            "telephone_number": "217-234-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAS SENIOR LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-02",
        "last_updated": "2016-05-02",
        "status": "A",
        "authorized_official_last_name": "MINTON",
        "authorized_official_first_name": "BLAIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-573-5105"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "IL",
            "license": "0053652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Marcum, CRNA
• Madisson Rose Marcum, CRNA
• Beth Ann Marlow, B.S.
• Flynn Mallory Marquart, BS
• Courtney Martin, PTA
• Elizabeth Mason, BA
• Makenna Mason, MA, MHP
• Allison Margret Masse
• Mark Masse, PT, MHS
• Sara N Masse, MPT

• Alzheimer Center (Dementia Center) in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Alzheimer Center (Dementia Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; 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.