NPI | 1790446383 |
---|---|
Doing Business As | IMBODEN CREEK SENIOR LIVING & REHABILITATION |
Entity Type | Organization |
Authorized Contact | SCOTT E STOUT Owner 618-294-8696 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility |
Enumeration Date | 2022-01-05 |
Last Update Date | 2022-04-25 |