| NPI | 1780602722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN TUDOR Administrator 618-488-2355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 0032979) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2011-11-02 |