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NPI Code Detail

MEDICARE: THE GROVE HEALTH AND REHAB CENTER LLC

MEDICARE: THE GROVE HEALTH AND REHAB CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1760172712
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE GROVE HEALTH AND REHAB CENTER LLC
Provider Business Mailing Address
First Line : 575 ROUTE 70
Second Line :
City : BRICK
State : NJ
Zip : 08723-4042
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 873 GROVE ST
Second Line :
City : JACKSONVILLE
State : IL
Zip : 62650-2828
Country : US
Telephone Number : 217-479-3400
Fax Number :
Authorized Official
Title or Position : MANAGER OF THE MANAGER
Name : SHULLY LICHTMAN
Credential :
Telephone Number : 217-479-3400
Provider Enumeration Date : 05/12/2023
Last Update Date : 05/12/2023

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Directions to “THE GROVE HEALTH AND REHAB CENTER LLC ” Practice Location

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