| NPI | 1134149529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MCGHEE Controller 217-732-5175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IA 780641) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: IA 780641) |
| 311500000X Alzheimer Center (Dementia Center) (Licence: IA 780641) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-08-22 |