Organization
MOMENCE MEADOWS NURSING & REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOISHE GUBIN (OWNER)
(815) 472-2423
Entity
Organization
Contact information
Practice address
500 S WALNUT ST, MOMENCE, IL 60954-1814
(815) 472-2423
(815) 472-6212
Mailing address
500 S WALNUT, MOMENCE, IL 60954
(815) 472-2423
(815) 472-6212
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0028480
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50263
BCBS PROVIDER NUMBER
IL
Enumeration date
08/31/2005
Last updated
04/20/2008
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