Organization
STONEBRIDGE SENIOR LIVING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT E. STOUT (MANAGER)
(618) 713-5284
Entity
Organization
Contact information
Practice address
902 S MCLEANSBORO ST, BENTON, IL 62812-3413
(618) 439-4501
(618) 435-3141
Mailing address
902 S MCLEANSBORO ST, PO BOX 968, BENTON, IL 62812-3413
(618) 439-4501
(618) 435-3141
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0051888
IL
Other
Enumeration date
03/01/2007
Last updated
02/14/2017
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