OrganizationActive
Vandalia Estates, LLC
NPI 1013113687 · Point of Service · Vandalia, IL
Provider details
- NPI number
- 1013113687
- Entity type
- Organization
- Primary specialty
- Point of ServiceManaged Care Organizations
- Organization subpart
- No
- Authorized official
- John Holtz, Controller(541) 747-3373
Specialties & taxonomies
Managed Care Organizations
Practice location
1607 W Fillmore St
Vandalia, IL 62471-3112
Phone: (618) 283-9825
Fax: (618) 283-9926
Approximate (ZIP-level) locationGet directions
Mailing address
78 Centennial Loop
Eugene, OR 97401-7900
Registry dates
- Enumerated
- 2007-06-21
- Last updated
- 2008-05-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.