| NPI | 1386895381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY D WOODARD Managing Member 217-202-6113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2008-10-08 |