| NPI | 1457476640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MIDDLETON Administrator 618-532-2428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IL 00045096) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |