| NPI | 1043217870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN P. MILLER Member 312-994-2306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 0046672) |
| Additional Taxonomies | 310500000X Intermediate Care Facility, Mental Illness (Licence: IL 0046672) |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: IL 0046672) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2013-02-27 |