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General NPI Number Information
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NPI Number | 1932392032
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Entity Type | Organization
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Legal Business Name | KENSINGTON OF GALESBURG
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 311 E SIMMONS ST
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City | GALESBURG
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State | IL
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Zip | 61401-4797
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Country | US
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Telephone | 309-342-2577
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Fax |
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Provider Business Mailing Address
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Address Line | 311 E SIMMONS ST
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City | GALESBURG
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State | IL
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Zip | 61401-4797
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Country | US
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Telephone | 309-342-2577
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. CHRISTINA CAMPBELL
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Credential | R. N.
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Telephone | 309-342-2577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 001
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License Number State | IL
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