Organization
NORTH ADAMS HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBYN JOHNSON RN, LNHA (ADMINISTRATOR)
(217) 936-2137
Entity
Organization
Contact information
Practice address
2259 E 1100TH ST, MENDON, IL 62351-2720
(217) 936-2137
(217) 936-3106
Mailing address
2259 E 1100TH ST, MENDON, IL 62351-2720
(217) 936-2137
(217) 936-3106
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0020925
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0020925
—
IL
Enumeration date
10/07/2005
Last updated
12/19/2011
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