| NPI | 1265443915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON O OKSNERAD Administrator 815-877-7408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 0018275) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: IL 0018275) |
| 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IL 0018275) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2009-12-28 |