GRAND VICTORIAN OF ROCKFORD, LLC

ROCKFORD, IL
NPI1891991550
Entity TypeOrganization
Authorized ContactJOHN HOLTZ
Controller
541-747-3373
Organization Subpart ?No
Primary Taxonomy305S00000X Point of Service
Enumeration Date2007-06-21
Last Update Date2008-05-13
Business Address
GRAND VICTORIAN OF ROCKFORD, LLC
3495 MCFARLAND RD
ROCKFORD, IL 61114-5609
Phone number: 815-654-1400
Mailing Address
GRAND VICTORIAN OF ROCKFORD, LLC
78 CENTENNIAL LOOP
EUGENE, OR 97401-7900
Phone number: 541-747-3373