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General NPI Number Information
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NPI Number | 1912139304
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Entity Type | Organization
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Legal Business Name | PARIS HEALTH CARE CENTER INVESTORS, LLC
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Dates
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Enumeration Date | 08/18/2009
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Last Update Date | 08/18/2009
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Provider Practice Location Address
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Address Line | 1011 N MAIN ST
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City | PARIS
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State | IL
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Zip | 61944-1145
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Country | US
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Telephone | 217-465-5376
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Fax | 217-465-8106
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Provider Business Mailing Address
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Address Line | 1011 N MAIN ST
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City | PARIS
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State | IL
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Zip | 61944-1145
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Country | US
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Telephone | 217-465-5376
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Fax | 217-465-8106
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. LESTER ROBERTSON
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Credential |
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Telephone | 217-465-5376
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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 | 0046565
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License Number State | IL
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