NPI | 1427499052 |
---|---|
Entity Type | Organization |
Authorized Contact | AMY BONTA Regional Director 618-541-4536 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 146.003911) |
Enumeration Date | 2013-07-11 |
Last Update Date | 2013-07-11 |