NPI | 1184626434 |
---|---|
Doing Business As | PROVIDENCE DOWNERS GROVE |
Entity Type | Organization |
Authorized Contact | JOHANNA R ZANDSTRA Compliance Officer 708-342-8137 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 0028605) |
Enumeration Date | 2005-06-01 |
Last Update Date | 2015-08-13 |