| NPI | 1922066000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN MILLER Administrator 217-245-4174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 1738336) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2020-08-22 |