NPI | 1467941070 |
---|---|
Doing Business As | EDENBROOK OF BELOIT |
Entity Type | Organization |
Authorized Contact | ROSTISLAV PUKSHANSKY Corporate Manager 773-825-3336 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility |
Enumeration Date | 2018-05-09 |
Last Update Date | 2018-05-09 |