| NPI | 1609864214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE BLACKLEDGE Bookkeeper 217-222-1480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 0045153) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2020-08-22 |