NPI | 1881679579 |
---|---|
Entity Type | Organization |
Authorized Contact | KIM WITTENBERG Administrator 815-844-5121 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 1630299) |
Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IL 1630299) |
Enumeration Date | 2005-12-14 |
Last Update Date | 2020-08-12 |