| NPI | 1942407200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA JANE FELLOWS Administrator 618-288-2211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: IL 001) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2022-07-21 |