Healthcare Provider Details

I. General information

NPI: 1144480369
Provider Name (Legal Business Name): ADORERS OF THE BLOOD OF CHRIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 06/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 PIONEER LN
RUMA IL
62278-2640
US

IV. Provider business mailing address

2 PIONEER LN
RUMA IL
62278-2640
US

V. Phone/Fax

Practice location:
  • Phone: 618-282-3848
  • Fax: 618-282-3266
Mailing address:
  • Phone: 618-282-3848
  • Fax: 618-282-3266

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: SANDRA DUVIC
Title or Position: ADMINISTRATOR
Credential:
Phone: 618-282-3848