Healthcare Provider Details

I. General information

NPI: 1851979280
Provider Name (Legal Business Name): NATURE TRAIL HEALTH AND REHAB CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S 34TH ST
MOUNT VERNON IL
62864-6232
US

IV. Provider business mailing address

575 ROUTE 70 FL 2
BRICK NJ
08723-4042
US

V. Phone/Fax

Practice location:
  • Phone: 618-242-5700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MEIR SINGER
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 917-873-2936