| NPI | 1255476560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEDE A WEDER Administrator 618-488-3565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 0045609) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2010-02-26 |