| NPI | 1942896915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF BAKER Interim Executive Director 618-394-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2020-12-14 |