| NPI | 1275589822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENYA MARIE WASHINGTON Administrator 618-337-9823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: IL 0045005) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2020-08-22 |