NPI | 1194724906 |
---|---|
Entity Type | Organization |
Authorized Contact | DIANA S KINGTON President 618-549-8331 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility |
Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility |
Enumeration Date | 2005-07-14 |
Last Update Date | 2020-08-22 |