OrganizationActive
Charleston Estates, LLC
NPI 1407052079 · Point of Service · Charleston, IL
Provider details
- NPI number
- 1407052079
- Entity type
- Organization
- Primary specialty
- Point of ServiceManaged Care Organizations
- Authorized official
- John Holtz, Controller
Practice location
300 Lincoln Highway Rd
Charleston, IL 61920-3884
Phone: (217) 348-6500
Fax: (217) 345-4096
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.