| NPI | 1215937867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONNI BULLINGTON Administrator 217-223-2636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 0011643) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IL 0011643) |
| 314000000X Skilled Nursing Facility | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2024-11-12 |