Healthcare Provider Details

I. General information

NPI: 1396284188
Provider Name (Legal Business Name): SALINE CARE NURSING & REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2017
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 S LAND ST
HARRISBURG IL
62946-1849
US

IV. Provider business mailing address

PO BOX 468
HARRISBURG IL
62946-0468
US

V. Phone/Fax

Practice location:
  • Phone: 618-252-7405
  • Fax: 618-253-3418
Mailing address:
  • Phone: 618-252-7405
  • Fax: 618-253-3418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. SCOTT E. STOUT
Title or Position: MANAGER
Credential:
Phone: 618-713-5284