| NPI | 1902051154 |
|---|---|
| Doing Business As | CALVIN JOHNSON CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | STEVEN C. WOLF President 618-234-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 0023309) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: IL 1400434197) |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2018-08-17 |