MEDICARE: SPRING VALLEY NURSING CENTER

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
1	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902971021
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRING VALLEY NURSING CENTER

Provider Business Mailing Address
First Line	:	1300 NORTH GREENWOOD ST
Second Line	:
City	:	SPRING VALLEY
State	:	IL
Zip	:	61362-1576
Country	:	US
Telephone Number	:	815-664-4708
Fax Number	:	815-663-2527

Provider Business Practice Location Address
First Line	:	1300 NORTH GREENWOOD ST
Second Line	:
City	:	SPRING VALLEY
State	:	IL
Zip	:	61362-1576
Country	:	US
Telephone Number	:	815-664-4708
Fax Number	:	815-663-2527

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. MORRIS STEINBERG
Credential	:
Telephone Number	:	815-664-4708

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	09/26/2011

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