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General NPI Number Information
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NPI Number | 1205170941
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Entity Type | Organization
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Legal Business Name | MORTON VILLA HEALTHCARE AND REHABILITATION CENTRE LLC
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Dates
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Enumeration Date | 11/19/2012
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Last Update Date | 08/09/2013
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Provider Practice Location Address
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Address Line | 190 E QUEENWOOD RD
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City | MORTON
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State | IL
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Zip | 61550-2926
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Country | US
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Telephone | 309-266-9741
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Fax | 309-266-0706
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Provider Business Mailing Address
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Address Line | 190 E QUEENWOOD RD
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City | MORTON
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State | IL
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Zip | 61550-2926
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Country | US
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Telephone | 309-266-9741
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Fax | 309-266-0706
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Authorized Official
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Title or Position | DIRECTOR OF ACCOUNTS RECEIVABLE
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Name | MS. KATHLEEN ADAMS
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Credential |
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Telephone | 773-897-9231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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