NPI | 1790132025 |
---|---|
Doing Business As | WALNUT GROVE LIVING CENTER |
Entity Type | Organization |
Authorized Contact | ISAAC DOLE Manager/Principal 773-645-9246 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility |
Enumeration Date | 2016-05-17 |
Last Update Date | 2024-10-29 |