| NPI | 1407008683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK PETERSEN Manager 309-691-8113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 0047415) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2008-10-21 |