NPI | 1265499354 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT TALBOT Administrator 309-755-3466 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 1713548) |
Enumeration Date | 2006-05-01 |
Last Update Date | 2022-07-21 |