Organization
HARBOR CREST HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRA A CHATTIC LNHA (ADMINISTRATOR)
(815) 589-3411
Entity
Organization
Contact information
Practice address
817 17TH ST, FULTON, IL 61252-1020
(815) 589-3411
(815) 589-4728
Mailing address
817 17TH ST, FULTON, IL 61252-1020
(815) 589-3411
(815) 589-4728
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
0009530
IL
Other
Enumeration date
10/12/2005
Last updated
10/23/2012
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