| NPI | 1326105636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT S EMLING Administrator 618-833-3602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: IL 0046599) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: IL 0046599) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2012-02-08 |