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Organization

HENRY & JANE VONDERLIETH LIVING CENTER INC

Active
Other names
The H & J Vonderlieth LVG CTR, The Henry & Jane Vonderlieth Living Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID M UNDERWOOD (SR. VP & CFO)
(309) 823-7135
Entity
Organization

Contact information

Practice address
1120 N TOPPER DR, MT PULASKI, IL 62548-1401
(217) 792-3218
(217) 792-3210
Mailing address
115 W JEFFERSON ST, STE 401, BLOOMINGTON, IL 61701-3967
(309) 828-4361
(309) 829-9512

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
19976
IL

Other

Enumeration date
09/16/2005
Last updated
05/30/2017
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