| NPI | 1407067978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN RUDOLPH BOUSE Staff Occupational Therapist 618-234-2120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: IL 056.004158) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2020-08-22 |