NPI | 1114142049 |
---|---|
Doing Business As | BROOKWOOD |
Entity Type | Organization |
Authorized Contact | JANE M DODSON Vice President 618-327-9846 |
Organization Subpart ? | No |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: IL 01s002) |
Enumeration Date | 2007-04-16 |
Last Update Date | 2020-08-22 |