Monroe County

NPI 1164424487 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1164424487
Enumeration Date 06/01/2005
Last Updated 06/24/2015
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name KIM LEE KIM
Position ADMINISTRATOR
Phone (618) 939-3488
Fax (918) 929-5030
Practice Location
623 HAMACHER STREET
WATERLOO IL, 62298-1598, US
Phone (618) 939-3488
Fax (918) 929-5030
Business Location
623 HAMACHER STREET
WATERLOO IL, 62298-1598, US
Phone (618) 939-3488
Fax (618) 939-5030
Toxanomy
Taxonomy Code 314000000X
License State Illinois
License Number =========001
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According to our database, Monroe County NPI is 1164424487, taxonomy code is 314000000X and license number is =========001, license state is located at Illinois. Monroe County physically located at 623 Hamacher Street, Waterloo IL, 62298-1598. NPI Number 1033115704 has the healthcare provider type.

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1164424487 NPI number is provided on an as is basis without warranty of any kind. 1164424487 is maintained by the National Plan & Provider Enumeration System. The contents of Monroe County are for informational purposes only.