Faith Countryside Homes

NPI 1114024213 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1114024213
Enumeration Date 09/20/2006
Last Updated 05/27/2010
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name GERALD GERALD
Position EXECUTIVE DIRECTOR
Phone (618) 654-4600
Fax (618) 654-4604
Practice Location
100 FAITH DR
HIGHLAND IL, 62249-2638, US
Phone (618) 654-4600
Fax (618) 654-4604
Business Location
100 FAITH DR
HIGHLAND IL, 62249-2638, US
Phone (618) 654-4600
Fax (618) 654-4604
Toxanomy
Taxonomy Code 314000000X
License State Illinois
License Number 0044552
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According to our database, Faith Countryside Homes NPI is 1114024213, taxonomy code is 314000000X and license number is 0044552, license state is located at Illinois. Faith Countryside Homes physically located at 100 Faith Dr, Highland IL, 62249-2638. NPI Number 1033115704 has the healthcare provider type.

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1114024213 NPI number is provided on an as is basis without warranty of any kind. 1114024213 is maintained by the National Plan & Provider Enumeration System. The contents of Faith Countryside Homes are for informational purposes only.