| NPI | 1174527758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDIA ANN MORAN Administrator 618-377-2144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IL 0021584) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2020-08-22 |