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General NPI Number Information
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NPI Number | 1821098211
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Entity Type | Organization
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Legal Business Name | AUBURN NURSING AND REHABILITATION CENTER LLC
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 11/01/2021
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Provider Practice Location Address
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Address Line | 304 W MAPLE AVE
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City | AUBURN
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State | IL
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Zip | 62615-1177
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Country | US
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Telephone | 217-438-6125
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Fax | 217-438-6316
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Provider Business Mailing Address
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Address Line | 304 W MAPLE AVE
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City | AUBURN
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State | IL
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Zip | 62615-1177
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Country | US
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Telephone | 217-438-6125
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Fax | 217-438-6316
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | JOSEPH C TUTERA
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Credential |
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Telephone | 816-444-0900
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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 | 0047076
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License Number State | IL
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