OrganizationActive
Prairie Village Supportive Living LLC
NPI 1518339167 · Assisted Living Facility · Rantoul, IL
Provider details
- NPI number
- 1518339167
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Parent organization
- Prairie Village Supportive Living LLC
- Organization subpart
- Yes
- Authorized official
- Joellen Bleavins, Vice President of Management Agent(815) 935-1992
Specialties & taxonomies
Nursing & Custodial Care Facilities
- Alzheimer Center (Dementia Center)311500000X
Nursing & Custodial Care Facilities
Practice location
200 International Drive
Rantoul, IL 61866
Phone: (217) 892-2800
Fax: (217) 892-2833
Approximate (ZIP-level) locationGet directions
Mailing address
200 International Drive
Rantoul, IL 61866
Registry dates
- Enumerated
- 2015-10-22
- Last updated
- 2015-11-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.