NPI | 1750553103 |
---|---|
Doing Business As | DAVIES SQUARE |
Entity Type | Organization |
Authorized Contact | RONALD J WILSON Authorized Agent 309-343-1550 |
Organization Subpart ? | Yes |
Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded (Licence: IL 31955) |
Enumeration Date | 2008-03-26 |
Last Update Date | 2008-04-20 |