NPI | 1811782477 |
---|---|
Entity Type | Organization |
Authorized Contact | LORI ARDELL WATSON "Owner 708-837-4308 |
Organization Subpart ? | No |
Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
Enumeration Date | 2025-04-14 |
Last Update Date | 2025-04-14 |