| NPI | 1104095736 |
|---|---|
| Other Name | TRINITY LIVING CENTER #2 |
| Entity Type | Organization |
| Authorized Contact | BOB TAYLOR CFO 815-320-7190 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2020-05-20 |