| NPI | 1629276225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE LEE SMALLWOOD Administrator 815-858-2275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IL 000008300) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2017-01-06 |