| NPI | 1013986439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY WYNN HOLTGREWE Administrator 618-475-2550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IL 0033043) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2013-08-06 |