| NPI | 1922332048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CELIA GRACE MONTES-KOLENCE Speech Language Therapist 618-580-8811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MO 2009021161) |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2009-09-22 |