| NPI | 1275781486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD HARMAN Executive Director 618-654-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 1866150) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: IL 183158) |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2008-08-29 |