Organization
527 CAPITAL GROUP
Active
Other names
Roseville Country Manor
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL D. OSTLIE (ADMINISTRATOR)
(309) 426-2134
Entity
Organization
Contact information
Practice address
145 S CHAMBERLAIN ST, ROSEVILLE, IL 61473-9581
(309) 426-2134
(309) 426-2445
Mailing address
145 S CHAMBERLAIN ST, ROSEVILLE, IL 61473-9581
(309) 426-2134
(309) 426-2445
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
47654
IL
Other
Enumeration date
06/09/2006
Last updated
08/22/2020
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