| NPI | 1649641580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KILEY HAVERA Occupational Therapist 217-710-0482 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 056011139) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2015-10-19 |