Healthcare Provider Details

I. General information

NPI: 1144975392
Provider Name (Legal Business Name): TAYLORVILLE SKILLED NURSING & REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2022
Last Update Date: 02/16/2022
Certification Date: 02/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MCADAM DR
TAYLORVILLE IL
62568-9634
US

IV. Provider business mailing address

575 ROUTE 70
BRICK NJ
08723-4042
US

V. Phone/Fax

Practice location:
  • Phone: 217-824-2277
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MEIR SINGER
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 217-824-2277