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 |