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Organization

ILLINOIS VETERANS HOME AT LASALLE

Active
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Organization

ILLINOIS VETERANS HOME AT LASALLE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN G. KOEHLER LNHA (ADMINISTRATOR)
(815) 223-0303
Entity
Organization

Contact information

Practice address
1015 OCONOR AVE, LA SALLE, IL 61301-1216
(815) 223-0303
(815) 223-5815
Mailing address
1015 OCONOR AVE, LA SALLE, IL 61301-1216
(217) 222-9487
(217) 222-8578

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
44115
IL
320700000X
Physical Disabilities Residential Treatment Facility
Primary
44115
IL
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL

Other

Enumeration date
01/03/2007
Last updated
05/24/2013
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