Organization
PARENTS AND FRIENDS OF THE SLC-HOME 1
Active
Parent organization
PARENTS AND FRIENDS OF THE SPECIALIZED LIVING CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARENTS AND FRIENDS OF THE SPECIALIZED LIVING CENTER
Authorized official
MR. CHARLES K KEIGLEY (ADMINISTRATOR)
(618) 277-7730
Entity
Organization
Contact information
Practice address
3 GUNDLACH PL, SWANSEA, IL 62226-4227
(618) 277-7730
(618) 277-5423
Mailing address
3 GUNDLACH PL, SWANSEA, IL 62226-4227
(618) 277-7730
(618) 277-5423
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
6012769
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6012769
—
IL
Enumeration date
03/03/2008
Last updated
03/03/2008
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