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1891991550
GRAND VICTORIAN OF ROCKFORD, LLC
ROCKFORD, IL
NPI
1891991550
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Entity Type
Organization
Authorized Contact
JOHN HOLTZ
Controller
541-747-3373
Organization Subpart ?
No
Primary Taxonomy
305S00000X Point of Service
Enumeration Date
2007-06-21
Last Update Date
2008-05-13
Business Address
GRAND VICTORIAN OF ROCKFORD, LLC
3495 MCFARLAND RD
ROCKFORD, IL 61114-5609
Phone number: 815-654-1400
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Mailing Address
GRAND VICTORIAN OF ROCKFORD, LLC
78 CENTENNIAL LOOP
EUGENE, OR 97401-7900
Phone number: 541-747-3373
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