| NPI | 1184613515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI L FRIZZI Assistant Administrator 618-945-2091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 0045617) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2011-12-02 |