Healthcare Provider Details

I. General information

NPI: 1821098211
Provider Name (Legal Business Name): AUBURN NURSING AND REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 11/01/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 W MAPLE AVE
AUBURN IL
62615-1177
US

IV. Provider business mailing address

304 W MAPLE AVE
AUBURN IL
62615-1177
US

V. Phone/Fax

Practice location:
  • Phone: 217-438-6125
  • Fax: 217-438-6316
Mailing address:
  • Phone: 217-438-6125
  • Fax: 217-438-6316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0047076
License Number StateIL

VIII. Authorized Official

Name: JOSEPH C TUTERA
Title or Position: PRESIDENT, CEO
Credential:
Phone: 816-444-0900