Organization
COULTERVILLE REHABILITATION & HEALTH CARE CENTER, LLC
Active
Other names
Coulterville Rehabilitation & Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH C TUTERA (OWNER)
(816) 444-0900
Entity
Organization
Contact information
Practice address
13138 STATE ROUTE 13, COULTERVILLE, IL 62237-1134
(618) 758-2256
(618) 758-3506
Mailing address
13138 STATE ROUTE 13, COULTERVILLE, IL 62237-1134
(618) 758-2256
(618) 758-3506
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0042820
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3641375870001
—
IL
05
—
364137587001
—
IL
Enumeration date
10/04/2005
Last updated
04/23/2021
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