Mt. Vernon Countryside Manor, Inc.

NPI 1033107248 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1033107248
Enumeration Date 10/11/2005
Last Updated 04/20/2008
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name DENISE M DENISE
Position VICE PRESIDENT OF OPERATIONS
Phone (618) 242-1800
Fax (618) 242-9080
Practice Location
606 E IL HIGHWAY 15
MOUNT VERNON IL, 62864-5072, US
Phone (618) 242-1800
Fax (618) 242-9080
Business Location
935 S MILL ST
NASHVILLE IL, 62263-2001, US
Phone (618) 327-3064
Fax (618) 327-3083
Toxanomy
Taxonomy Code 314000000X
License State Illinois
License Number 1656261
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According to our database, Mt. Vernon Countryside Manor, Inc. NPI is 1033107248, taxonomy code is 314000000X and license number is 1656261, license state is located at Illinois. Mt. Vernon Countryside Manor, Inc. physically located at 606 E Il Highway 15, Mount Vernon IL, 62864-5072. NPI Number 1033115704 has the healthcare provider type.

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1033107248 NPI number is provided on an as is basis without warranty of any kind. 1033107248 is maintained by the National Plan & Provider Enumeration System. The contents of Mt. Vernon Countryside Manor, Inc. are for informational purposes only.