| NPI | 1710975842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBEKAH MAHONEY Administrator 618-524-2683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 0017996) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2012-01-27 |